Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri.
Department of Neurological Surgery, Cleveland Clinic, Cleveland, Ohio.
Neurosurgery. 2018 Sep 1;83(3):556-565. doi: 10.1093/neuros/nyx518.
Glioblastoma of the corpus callosum is particularly difficult to treat, as the morbidity of surgical resection generally outweighs the potential survival benefit. Laser interstitial thermal therapy (LITT) is a safe and effective treatment option for difficult to access malignant gliomas of the thalamus and insula.
To assess the safety and efficacy of LITT for the treatment of glioblastoma of the corpus callosum.
We performed a multicenter retrospective analysis of prospectively collected data. The primary endpoint was the safety and efficacy of LITT as a treatment for glioblastoma of the corpus callosum. Secondary endpoints included tumor coverage at thermal damage thresholds, median survival, and change in Karnofsky Performance Scale score 1 mo after treatment.
The study included patients with de novo or recurrent glioblastoma of the corpus callosum (n = 15). Mean patient age was 54.7 yr. Mean pretreatment Karnofsky Performance Scale score was 80.7 and there was no significant difference between subgroups. Mean tumor volume was 18.7 cm3. Hemiparesis occurred in 26.6% of patients. Complications were more frequent in patients with tumors >15 cm3 (RR 6.1, P = .009) and were associated with a 32% decrease in survival postLITT. Median progression-free survival, survival postLITT, and overall survival were 3.4, 7.2, and 18.2 mo, respectively.
LITT is a safe and effective treatment for glioblastoma of the corpus callosum and provides survival benefit comparable to subtotal surgical resection with adjuvant chemoradiation. LITT-associated complications are related to tumor volume and can be nearly eliminated by limiting the procedure to tumors of 15 cm3 or less.
胼胝体胶质母细胞瘤的治疗特别困难，因为手术切除的发病率通常超过潜在的生存获益。激光间质热疗（LITT）是一种安全有效的治疗丘脑和脑岛难以触及的恶性胶质瘤的方法。
评估 LITT 治疗胼胝体胶质母细胞瘤的安全性和有效性。
我们对前瞻性收集的数据进行了多中心回顾性分析。主要终点是 LITT 作为胼胝体胶质母细胞瘤治疗方法的安全性和有效性。次要终点包括在热损伤阈值下肿瘤的覆盖范围、中位生存时间以及治疗后 1 个月 Karnofsky 表现量表评分的变化。
该研究纳入了胼胝体新发或复发性胶质母细胞瘤患者（n = 15）。患者平均年龄为 54.7 岁。平均预处理 Karnofsky 表现量表评分为 80.7，亚组之间无显著差异。平均肿瘤体积为 18.7cm3。偏瘫发生在 26.6%的患者中。肿瘤>15cm3的患者并发症更为常见（RR 6.1，P =.009），与 LITT 后生存率下降 32%相关。无进展生存、LITT 后生存和总生存的中位数分别为 3.4、7.2 和 18.2 个月。
LITT 是治疗胼胝体胶质母细胞瘤的一种安全有效的方法，提供的生存获益与辅助放化疗的次全手术切除相当。与 LITT 相关的并发症与肿瘤体积有关，通过将手术限制在 15cm3 或更小的肿瘤中，几乎可以消除这些并发症。
