Introduction: MRI-guided laser interstitial thermal therapy (MRgLITT) is a percutaneous, minimally invasive procedure that is an emerging technique for the treatment of a variety of pathologies. Our study aims to assess the safety and effectiveness of MRgLITT for high-grade gliomas (HGGs).
Methods: We performed a retrospective analysis of prospectively collected patient data at the University of Texas MD Anderson Cancer Center.
Results: 57 patients with HGGs (n = 17 de novo, n = 40 recurrent) were included in our study. Mean patient age was 52 years, median length of follow-up was 14.46 months, and median time to discharge was 2 days. Median tumor volume was 11.48 cm3, while median Karnofsky Performance Scale (KPS) score before and after treatment was 80. 22 patients (39%) had tumors in deep-seated locations (basal ganglia, corpus callosum, insula, thalamus). Median ablation volume was 15.44 cm3 and median untreated tumor volume was 1.5 cm3. 18 patients (32%) experienced worsened or new-onset post-operative hemiparesis that persisted on follow-up after 6 months. 33 patients (58%) experienced local recurrence, and the median time to local recurrence was 4.63 months. From last follow-up, 24 patients (42%) are deceased. Median overall survival was 30.8 months. Multivariable cox regression analysis showed tumor volume as a negative predictor of overall survival. Overall survival did not differ between the de novo or recurrent HGG groups. Deep-seated tumor location had no effect on complications, time to local recurrence, or overall survival.
Conclusions: MRgLITT is a safe and effective treatment for HGGs. It can be a useful alternative to surgical resection for HGGs in deep-seated locations.
Patient Care: Our study provides further data on the use of LITT for HGGs. Though LITT cannot be used to cure patients with HGGs, it can be a very useful alternative to surgical resection for patients with HGGs in deep-seated locations, where the morbidity from surgical resection generally outweighs the potential survival benefit.
Learning Objectives: 1. Describe the importance of LITT in the treatment of HGGs.
2. Discuss the potential benefits of using LITT as an alternative treatment option to surgical resection for patients with HGGs.
3. Identify the role of LITT for patients with HGGs, especially when considering the treatment of HGGs in deep-seated locations.