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应用机器人 NeuroBlate 系统激光消融异常神经组织(LAANTERN):脑肿瘤消融 12 个月的结果和生活质量

Laser Ablation of Abnormal Neurological Tissue Using Robotic NeuroBlate System (LAANTERN): 12-Month Outcomes and Quality of Life After Brain Tumor Ablation.

机构信息

Department of Neurosurgery, Washington University, St. Louis, Missouri.

Department of Neurosurgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina.

出版信息

Neurosurgery. 2020 Sep 1;87(3):E338-E346. doi: 10.1093/neuros/nyaa071.

Abstract

BACKGROUND

Laser Ablation of Abnormal Neurological Tissue using Robotic NeuroBlate System (LAANTERN) is an ongoing multicenter prospective NeuroBlate (Monteris Medical) LITT (laser interstitial thermal therapy) registry collecting real-world outcomes and quality-of-life (QoL) data.

OBJECTIVE

To compare 12-mo outcomes from all subjects undergoing LITT for intracranial tumors/neoplasms.

METHODS

Demographics, intraprocedural data, adverse events, QoL, hospitalizations, health economics, and survival data are collected; standard data management and monitoring occur.

RESULTS

A total of 14 centers enrolled 223 subjects; the median follow-up was 223 d. There were 119 (53.4%) females and 104 (46.6%) males. The median age was 54.3 yr (range 3-86) and 72.6% had at least 1 baseline comorbidity. The median baseline Karnofsky Performance Score (KPS) was 90. Of the ablated tumors, 131 were primary and 92 were metastatic. Most patients with primary tumors had high-grade gliomas (80.9%). Patients with metastatic cancer had recurrence (50.6%) or radiation necrosis (40%). The median postprocedure hospital stay was 33.4 h (12.7-733.4). The 1-yr estimated survival rate was 73%, and this was not impacted by disease etiology. Patient-reported QoL as assessed by the Functional Assessment of Cancer Therapy-Brain was stabilized postprocedure. KPS declined by an average of 5.7 to 10.5 points postprocedure; however, 50.5% had stabilized/improved KPS at 6 mo. There were no significant differences in KPS or QoL between patients with metastatic vs primary tumors.

CONCLUSION

Results from the ongoing LAANTERN registry demonstrate that LITT stabilizes and improves QoL from baseline levels in a malignant brain tumor patient population with high rates of comorbidities. Overall survival was better than anticipated for a real-world registry and comparative to published literature.

摘要

背景

神经消融机器人系统(NeuroBlate 系统)用于异常神经组织的激光消融(LAANTERN)是一项正在进行的多中心前瞻性神经消融(Monteris Medical)激光间质热疗(LITT)注册研究,旨在收集真实世界的结果和生活质量(QoL)数据。

目的

比较所有接受颅内肿瘤/肿瘤 LITT 治疗的患者 12 个月的结果。

方法

收集人口统计学、术中数据、不良事件、QoL、住院、健康经济学和生存数据;进行标准的数据管理和监测。

结果

共有 14 个中心入组 223 例患者;中位随访时间为 223 天。女性 119 例(53.4%),男性 104 例(46.6%)。中位年龄为 54.3 岁(范围 3-86 岁),72.6%的患者至少有 1 种基线合并症。基线 Karnofsky 表现评分(KPS)的中位数为 90 分。消融的肿瘤中,原发性肿瘤 131 例,转移性肿瘤 92 例。大多数原发性肿瘤患者为高级别胶质瘤(80.9%)。转移性癌症患者的复发率(50.6%)或放射性坏死率(40%)较高。术后中位住院时间为 33.4 小时(12.7-733.4)。1 年估计生存率为 73%,且不受疾病病因影响。术后患者报告的生活质量(QoL)由癌症治疗脑功能评估量表评估,趋于稳定。KPS 术后平均下降 5.7 至 10.5 分;然而,50.5%的患者在 6 个月时 KPS 稳定/改善。转移性肿瘤与原发性肿瘤患者的 KPS 或 QoL 无显著差异。

结论

正在进行的 LAANTERN 注册研究结果表明,在患有恶性脑肿瘤且合并症高发的患者中,LITT 可稳定并改善基线水平的 QoL。总生存率优于预期,与已发表的文献相当。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b02b/7534487/be7b32f46592/nyaa071ga.jpg

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