Department of Neurosurgery, Azienda Ospedaliera Universitaria Pisana (AOUP), Pisa, Italy; Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
Department of Neurosurgery, Azienda Ospedaliera Universitaria Pisana (AOUP), Pisa, Italy.
Clin Neurol Neurosurg. 2020 Aug;195:105942. doi: 10.1016/j.clineuro.2020.105942. Epub 2020 May 21.
To study the role of laser interstitial thermal therapy in recurrent glioblastoma and to assess its effect in the overall survival and in progression-free survival.
A MEDLINE and Pubmed search was performed for the key words "laser interstitial thermal therapy", "LITT" and "glioblastoma". Studies investigating overall survival and progression-free survival of recurrent glioblastoma after laser interstitial thermal therapy were selected.
A total of 17 studies met the selection criteria, accounting for 203 patients with recurrent glioblastoma who underwent 219 laser interstitial thermal therapy treatments. The median age was 57.4 years and there was male predominance (65.8 % male Vs 34.2 % female). The most common location resulted frontal lobe (29 %), followed by temporal (23.9 %), parietal (21.4 %) and occipital lobes (2.6 %). Additional locations included thalamus, corpus callosum and cerebellum (23.1 %). Pre-treatment median tumor size was 8.9 cm. Morbidity was 6.4 % with a median hospital stay of 3.5 days. The most common complications were seizures (2%), motor deficits (1.5 %), wound infection (1.5 %), transient hemiparesis (1%) and hemorrhage (0.5 %). No deaths were reported due to LITT procedure. The median progression-free survival and the median overall survival after laser interstitial thermal therapy resulted 5.6 months and 10.2 months, respectively. The median overall survival from diagnosis was 14.7 months. All patients underwent adjuvant chemotherapy after treatment.
Laser interstitial thermal therapy provides an effective treatment with low morbidity for selected patients harboring recurrent glioblastoma. Laser interstitial thermal therapy should be included in the armamentarium of neurosurgical oncologist for treatment of recurrent glioblastomas.
研究激光间质热疗在复发性脑胶质瘤中的作用,并评估其对总生存期和无进展生存期的影响。
通过 MEDLINE 和 Pubmed 搜索关键词“激光间质热疗”、“LITT”和“脑胶质瘤”,选择研究激光间质热疗后复发性脑胶质瘤总生存期和无进展生存期的文献。
共有 17 项研究符合选择标准,共纳入 203 例接受 219 次激光间质热疗的复发性脑胶质瘤患者。中位年龄为 57.4 岁,男性占 65.8%(男性 136 例,女性 67 例)。最常见的病变部位是额叶(29%),其次是颞叶(23.9%)、顶叶(21.4%)和枕叶(2.6%)。其他部位包括丘脑、胼胝体和小脑(23.1%)。治疗前肿瘤中位大小为 8.9cm。发病率为 6.4%,中位住院时间为 3.5 天。最常见的并发症为癫痫发作(2%)、运动障碍(1.5%)、伤口感染(1.5%)、短暂偏瘫(1%)和出血(0.5%)。无患者因 LITT 手术死亡。激光间质热疗后中位无进展生存期和总生存期分别为 5.6 个月和 10.2 个月,治疗后诊断的中位总生存期为 14.7 个月。所有患者在治疗后均接受辅助化疗。
激光间质热疗为复发性脑胶质瘤患者提供了一种有效的治疗方法,发病率低。激光间质热疗应作为神经外科肿瘤医生治疗复发性脑胶质瘤的手段之一。