Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.
Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.
World Neurosurg. 2020 Dec;144:e156-e163. doi: 10.1016/j.wneu.2020.08.053. Epub 2020 Aug 11.
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.
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.
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.
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.
由于侵袭性手术切除会导致发病率升高，因此对于胼胝体多形性胶质母细胞瘤（GBM），许多情况下的治疗策略仍然局限于立体定向活检。
我们对 3 例经组织学证实的胼胝体 GBM 患者进行了研究，这些患者均接受了双侧激光间质热疗（LITT）。收集的数据包括人口统计学、肿瘤位置和体积、肿瘤遗传标志物、治疗体积、围手术期并发症以及术前和术后卡氏功能状态量表（KPS）评分。
我们对 3 例胼胝体 GBM 患者进行了 6 次 LITT 治疗。患者的平均年龄为 64 岁，肿瘤平均体积为 14.95cm。平均术前 KPS 评分为 80 分，术后 1 个月 KPS 评分无明显变化。术后磁共振成像上的平均消融程度为 98.6%，无患者发生围手术期并发症。8 个月的随访中，3 例患者中有 2 例存活且神经状态稳定，与术前相比无进展。第 3 例患者选择推迟放疗和肿瘤治疗，并失访。无进展生存的平均时间为 3.55 个月，随访影像学研究中可见间隔卫星病变。
尽管我们的病例系列较小，但我们首次证明，就我们所知，双侧 LITT 是胼胝体 GBM 的一种安全有效的治疗方法。鉴于高级别胶质瘤近全切除的已知益处，我们认为 LITT 可能会改善这些否则将接受活检的患者的生存。
