Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Neurosurgical Oncology Unit, Surgical Neurology Branch, National Institutes of Neurological Disorders and Stroke, NIH, Bethesda, Maryland, USA.
World Neurosurg. 2021 Sep;153:91-97.e1. doi: 10.1016/j.wneu.2021.05.114. Epub 2021 Jun 1.
OBJECTIVE/BACKGROUND: The efficacy of laser interstitial thermal therapy (LITT) in recurrent glioblastoma (rGBM) is unknown. The goal of this study was to conduct a systematic review and pooled analysis of the literature for outcomes on patients with rGBM undergoing LITT.
A literature search was performed to retrieve all studies investigating overall survival, postprocedure survival, and progression-free survival outcomes of patients with rGBM undergoing LITT. Statistics were pooled together by meta-analysis of mean using a weighted random-effects or fixed-effect model.
Eleven studies were included in the final cohort, representing a total of 134 patients with rGBM. The pooled mean age of the cohort at the time of recurrence was 56.7 ± 4.56 years; 41% of the cohort were female. For delivery of LITT, 2 studies used neodymium-yttrium aluminum-garnet laser (Nd:YAG laser), 3 studies used the Visualase system, 5 studies used the NeuroBlate system, and 1 study used both the NeuroBlate and the Visualase system. A total of 8 studies with 107 patients had available data for overall median survival. The pooled overall survival was found to be 18.6 months (95% confidence interval [CI] 16.2-21.1). A total of 6 studies with 93 patients had available data for post-LITT survival. The pooled post-LITT survival was found to be 10.1 months (95% CI 8.8-11.6). A total of 8 studies with 119 patients had available data for progression-free survival. Pooled progression free survival was found to be 6 months (95% CI 5.3-6.7).
LITT is a novel minimally invasive procedure which, when used with optimal adjuvant therapy, may confer survival benefit for patients with rGBM.
目的/背景：激光间质热疗（LITT）治疗复发性胶质母细胞瘤（rGBM）的疗效尚不清楚。本研究的目的是对接受 LITT 治疗的 rGBM 患者的文献进行系统回顾和汇总分析，以评估其结局。
进行文献检索，以检索所有研究 rGBM 患者接受 LITT 治疗的总生存率、术后生存率和无进展生存率的研究。通过使用加权随机效应或固定效应模型对平均值进行荟萃分析，将统计学数据汇总在一起。
最终队列纳入了 11 项研究，共纳入了 134 例 rGBM 患者。在复发时，队列的汇总平均年龄为 56.7 ± 4.56 岁；41%的患者为女性。在 LITT 治疗中，2 项研究使用了钕钇铝石榴石激光（Nd:YAG 激光），3 项研究使用了 Visualase 系统，5 项研究使用了 NeuroBlate 系统，1 项研究同时使用了 NeuroBlate 和 Visualase 系统。有 8 项研究共 107 例患者有总体中位生存时间的数据。汇总的总体生存率为 18.6 个月（95%置信区间 [CI] 16.2-21.1）。有 6 项研究共 93 例患者有术后生存数据。汇总的术后 LITT 生存率为 10.1 个月（95% CI 8.8-11.6）。有 8 项研究共 119 例患者有无进展生存数据。无进展生存的汇总率为 6 个月（95% CI 5.3-6.7）。
LITT 是一种新的微创治疗方法，当与最佳辅助治疗联合使用时，可能为 rGBM 患者带来生存获益。
