Ivan Michael E, Diaz Roberto Jose, Berger Michael H, Basil Gregory W, Osiason David A, Plate Thomas, Wallo Amanda, Komotar Ricardo J
Department of Neurological Surgery, The Sylvester Comprehensive Cancer Center, Miami, Florida, USA; Department of Neurological Surgery, The University of Miami Miller School of Medicine, Miami, Florida, USA.
Department of Neurological Surgery, The University of Miami Miller School of Medicine, Miami, Florida, USA.
World Neurosurg. 2017 Feb;98:162-170. doi: 10.1016/j.wneu.2016.10.037. Epub 2016 Oct 17.
Magnetic resonance-guided laser-induced thermotherapy (MR-LITT) is a minimally invasive technique that shows promise in neuro-oncology because of its superiority in delivering precise minimally invasive thermal energy with minimal collateral damage. In this analysis, we investigate initial data on the effect of MR-LITT on dural-based lesions.
Five patients were identified with dural-based lesions (4 meningiomas, 1 solitary fibrous tumor) with clear evidence of radiologic progression. In all 5 cases, the tumors were localized to the lateral convexity or paramedian locations in the supratentorial space. All patients received MR-LITT and then a follow-up magnetic resonance imaging scan at 24 hours after treatment, at 1 month, and at each subsequent follow-up visit. Local control of the ablated tumor was evaluated with radiographic follow-up and symptomatic progression-free survival was recorded.
Five LITT treatments were performed on 5 patients with an average age of 65.2 years. The average tumor volume was 29.7 cm and ablation dosage was 12.4 W. On average, 80% of the pretreatment lesion volume was ablated. The mean follow-up time was 59.3 weeks. In total, 2 patients (1 with an anaplastic meningioma and 1 with a solitary fibrous tumor) had radiographic evidence of disease progression. In the observed time of the 3 patients with no progression, there was a 52% reduction in tumor volume. There were no major perioperative complications.
MR-LITT is a promising technology for dural-based lesion treatment. This initial study demonstrates that MR-LITT is safe and offers several advantages over open surgical treatment. Randomized studies are needed to evaluate its role as a treatment adjunct.
磁共振引导激光诱导热疗（MR-LITT）是一种微创技术，因其在提供精确的微创热能且附带损伤最小方面具有优势，在神经肿瘤学领域展现出前景。在本分析中，我们研究了MR-LITT对硬脑膜病变的影响的初始数据。
确定了5例有硬脑膜病变（4例脑膜瘤，1例孤立性纤维瘤）且有明确影像学进展证据的患者。在所有5例病例中，肿瘤均位于幕上空间的外侧凸面或旁正中位置。所有患者均接受了MR-LITT治疗，然后在治疗后24小时、1个月以及随后的每次随访时进行磁共振成像扫描。通过影像学随访评估消融肿瘤的局部控制情况，并记录无症状进展生存期。
对5例平均年龄为65.2岁的患者进行了5次LITT治疗。平均肿瘤体积为29.7 cm，消融剂量为12.4 W。平均而言，80%的治疗前病变体积被消融。平均随访时间为59.3周。总共有2例患者（1例间变性脑膜瘤和1例孤立性纤维瘤）有疾病进展的影像学证据。在观察期内，3例无进展的患者肿瘤体积减少了52%。未发生重大围手术期并发症。
MR-LITT是一种有前景的硬脑膜病变治疗技术。这项初步研究表明，MR-LITT是安全的，且与开放手术治疗相比具有若干优势。需要进行随机研究以评估其作为治疗辅助手段的作用。
