Department of Neurosurgery, UMDNJ--New Jersey Medical School, Newark, New Jersey 08901, USA.
Neurosurgery. 2012 Sep;71(1 Suppl Operative):133-44; 144-5. doi: 10.1227/NEU.0b013e31826101d4.
Laser-induced thermal therapy is a promising tool in the neurosurgeon's armamentarium. This methodology has seen a resurgence in application as a result of advances in technology.
To report our initial experience with the procedure after treating 20 consecutive patients, the largest series to date.
Patients were selected for laser therapy if they had failed conventional therapies, were unable to tolerate an open cranial procedure, or the tumor was deemed otherwise inoperable. In this series, 980-nm diode laser catheters were placed stereotactically in the operating room. The patients were then transferred to the magnetic resonance imaging suite for thermal ablation.
A total of 31 laser applicators were placed in 20 patients with intracranial neoplasms. The majority of patients (17 of 20) had prior treatment for their tumors. The overall accuracy of laser insertion was 83.9%, improving with increased experience. The average lesion volume treated was 7.0 ± 9.0 cm2. With the use of damage estimates from the software provided, the treatment continued until the entire tumor had been irreversibly ablated. The average length of hospitalization was 2.27 days, with the majority of patients going home on postoperative day 1. Complications occurred in 4 patients, typically in those who were in poor health preoperatively.
Laser-induced thermal therapy is an intuitive procedure for treating difficult intracranial neoplasms. As with any other procedure, patient selection and lesion selection are important factors in determining outcome.
激光诱导热疗是神经外科医生的一种有前途的工具。由于技术的进步，该方法的应用再次兴起。
报告我们对 20 例连续患者进行该治疗的初步经验，这是迄今为止最大的系列。
如果患者经常规治疗失败、无法耐受开颅手术或肿瘤被认为无法手术，则选择进行激光治疗。在该系列中，980nm 二极管激光导管在手术室中立体定向放置。然后将患者转移到磁共振成像套件进行热消融。
在 20 名患有颅内肿瘤的患者中总共放置了 31 个激光施源器。大多数患者（20 例中有 17 例）曾接受过肿瘤治疗。激光插入的总体准确性为 83.9%，随着经验的增加而提高。治疗的平均病变体积为 7.0±9.0cm3。使用软件提供的损伤估计值，治疗继续进行，直到整个肿瘤被不可逆地消融。平均住院时间为 2.27 天，大多数患者在术后第 1 天回家。4 名患者发生并发症，通常是术前身体状况不佳的患者。
激光诱导热疗是治疗困难性颅内肿瘤的直观方法。与任何其他程序一样，患者选择和病变选择是确定结果的重要因素。
