Safety Analysis of Bilateral Laser Interstitial Thermal Therapy for Treatment of Butterfly Glioma.

BACKGROUND

Treatment strategies for glioblastoma multiforme (GBM) of the corpus callosum have remained limited to stereotactic biopsy in many cases owing to the morbidity resulting from aggressive surgical resection.

METHODS

We performed a study of 3 patients with histologically proven GBM of the corpus callosum who had undergone bilateral laser interstitial thermal therapy (LITT). The data collected included demographics, tumor location and volume, tumor genetic markers, treatment volume, perioperative complications, and Karnofsky performance scale (KPS) score pre- and postoperatively.

RESULTS

We performed 6 LITT sessions for the 3 patients with GBM of the corpus callosum. The mean patient age was 64 years, with an average tumor volume of 14.95 cm. The mean pretreatment KPS score was 80, and no significant changes were found in the KPS scores at 1 month postoperatively. The mean extent of ablation was 98.6% on postoperative magnetic resonance imaging, and none of the patients had experienced perioperative complications. At 8 months of follow-up, 2 of the 3 patients were alive and neurologically stable compared with their preoperative state. The third patient had elected to defer radiotherapy and oncology treatment and was lost to follow-up. The mean progression-free survival was 3.55 months, with interval satellite lesions seen on follow-up imaging studies.

CONCLUSION

Although our case series was small, we have demonstrated for the first time, to the best of our knowledge, that bilateral LITT is a safe and effective treatment of GBM of the corpus callosum. Given the known benefit of near gross total resection for high-grade glioma, we believe LITT might improve survival for these patients who otherwise would have undergone biopsy.