Thomas Jonathan G, Rao Ganesh, Kew Yvonne, Prabhu Sujit S
Department of Neurosurgery, University of Texas MD Anderson Cancer Center; and.
Department of Neurology, Houston Methodist Hospital, Houston, Texas.
Neurosurg Focus. 2016 Oct;41(4):E12. doi: 10.3171/2016.7.FOCUS16234.
OBJECTIVE Glioblastoma (GBM) is the most common and deadly malignant primary brain tumor. Better surgical therapies are needed for newly diagnosed GBMs that are difficult to resect and for GBMs that recur despite standard therapies. The authors reviewed their institutional experience of using laser interstitial thermal therapy (LITT) for the treatment of newly diagnosed or recurrent GBMs. METHODS This study reports on the pre-LITT characteristics and post-LITT outcomes of 8 patients with newly diagnosed GBMs and 13 patients with recurrent GBM who underwent LITT. RESULTS Compared with the group with recurrent GBMs, the patients with newly diagnosed GBMs who underwent LITT tended to be older (60.8 vs 48.9 years), harbored larger tumors (22.4 vs 14.6 cm), and a greater proportion had IDH wild-type GBMs. In the newly diagnosed GBM group, the median progression-free survival and the median survival after the procedure were 2 months and 8 months, respectively, and no patient demonstrated radiographic shrinkage of the tumor on follow-up imaging. In the 13 patients with recurrent GBM, 5 demonstrated a response to LITT, with radiographic shrinkage of the tumor following ablation. The median progression-free survival was 5 months, and the median survival was greater than 7 months. CONCLUSIONS In carefully selected patients with recurrent GBM, LITT may be an effective alternative to surgery as a salvage treatment. Its role in the treatment of newly diagnosed unresectable GBMs is not established yet and requires further study.
目的 胶质母细胞瘤（GBM）是最常见且致命的原发性恶性脑肿瘤。对于难以切除的新诊断GBM以及尽管接受了标准治疗仍复发的GBM，需要更好的手术治疗方法。作者回顾了他们使用激光间质热疗（LITT）治疗新诊断或复发性GBM的机构经验。方法 本研究报告了8例接受LITT治疗的新诊断GBM患者和13例复发性GBM患者在LITT治疗前的特征及治疗后的结果。结果 与复发性GBM组相比，接受LITT治疗的新诊断GBM患者往往年龄更大（60.8岁对48.9岁），肿瘤更大（22.4 cm对14.6 cm），且IDH野生型GBM的比例更高。在新诊断的GBM组中，术后无进展生存期和中位生存期分别为2个月和8个月，且在随访影像学检查中无患者显示肿瘤有影像学缩小。在13例复发性GBM患者中，5例对LITT有反应，消融后肿瘤有影像学缩小。中位无进展生存期为5个月，中位生存期大于7个月。结论 在经过精心挑选的复发性GBM患者中，LITT作为挽救性治疗可能是一种有效的手术替代方法。其在治疗新诊断的不可切除GBM中的作用尚未确立，需要进一步研究。
