Karampelas Ioannis, Sloan Andrew E
Prog Neurol Surg. 2018;32:14-26. doi: 10.1159/000469676. Epub 2018 Jul 10.
Laser-induced interstitial thermotherapy (LITT) is a modern minimally invasive treatment modality applied for management of a variety of diseases. Recent developments of techniques for precise targeting of the lesion, accurate delivery of the prescribed therapeutically effective thermal doses, and real-time visualization of the induced tissue damage during the procedure by means of intraoperative MR thermometry have stimulated a number of clinical studies testing LITT in cases of different brain pathologies, including gliomas. This modality is particularly attractive in patients with recurrent, deep-seated, and/or critically located neoplasms refractory to other treatments, where it can effectively demonstrate improvement of prognosis providing high quality of life and eliminating the risks of open tumor resection. Low morbidity rates associated with LITT and short hospital stay result in decreased cost of hospitalization. The effectiveness of thermal therapies, particularly after long-term follow-up, still needs evaluation in carefully planned randomized clinical trials, whereas elucidating the effects of laser treatment at the molecular, cellular, and organic levels will continue to expand the boundaries of its clinical applicability in neuro-oncology.
激光诱导间质热疗（LITT）是一种用于治疗多种疾病的现代微创治疗方式。近期，通过术中磁共振热成像技术精确靶向病变、准确输送规定的治疗有效热剂量以及实时可视化手术过程中诱导的组织损伤等技术的发展，激发了多项针对不同脑部病变（包括胶质瘤）进行LITT测试的临床研究。这种治疗方式对于其他治疗方法难以治疗的复发性、深部和/或关键部位肿瘤患者尤为有吸引力，在这些患者中，它可以有效改善预后，提高生活质量并消除开放性肿瘤切除的风险。与LITT相关的低发病率和较短的住院时间降低了住院成本。热疗的有效性，尤其是长期随访后的有效性，仍需要在精心设计的随机临床试验中进行评估，而阐明激光治疗在分子、细胞和器官水平的作用将继续扩大其在神经肿瘤学中的临床应用范围。
