Pandey Aryan, Chandla Anubhav, Mekonnen Mahlet, Hovis Gabrielle E A, Teton Zoe E, Patel Kunal S, Everson Richard G, Wadehra Madhuri, Yang Isaac
Department of Neurosurgery, University of California Los Angeles (UCLA), Los Angeles, CA 90095, USA.
Harbor-UCLA Medical Center, Torrance, CA 90502, USA.
Cancers (Basel). 2024 Jun 3;16(11):2131. doi: 10.3390/cancers16112131.
Although primary studies have reported the safety and efficacy of LITT as a primary treatment in glioma, they are limited by sample sizes and institutional variation in stereotactic parameters such as temperature and laser power. The current literature has yet to provide pooled statistics on outcomes solely for primary brain tumors according to the 2021 WHO Classification of Tumors of the Central Nervous System (WHO CNS5). In the present study, we identify recent articles on primary CNS neoplasms treated with LITT without prior intervention, focusing on relationships with molecular profile, PFS, and OS. This meta-analysis includes the extraction of data from primary sources across four databases using the Covidence systematic review manager. The pooled data suggest LITT may be a safe primary management option with tumor ablation rates of 94.8% and 84.6% in IDH-wildtype glioblastoma multiforme (GBM) and IDH-mutant astrocytoma, respectively. For IDH-wildtype GBM, the pooled PFS and OS were 5.0 and 9.0 months, respectively. Similar to rates reported in the prior literature, the neurologic and non-neurologic complication rates for IDH-wildtype GBM were 10.3% and 4.8%, respectively. The neurologic and non-neurologic complication rates were somewhat higher in the IDH-mutant astrocytoma cohort at 33% and 8.3%, likely due to a smaller cohort size.
尽管有初步研究报告了激光间质热疗(LITT)作为胶质瘤主要治疗方法的安全性和有效性,但这些研究受到样本量以及立体定向参数(如温度和激光功率)的机构差异的限制。目前的文献尚未根据2021年世界卫生组织中枢神经系统肿瘤分类(WHO CNS5)提供仅针对原发性脑肿瘤结局的汇总统计数据。在本研究中,我们确定了近期未经预先干预而采用LITT治疗原发性中枢神经系统肿瘤的文章,重点关注其与分子特征、无进展生存期(PFS)和总生存期(OS)的关系。这项荟萃分析包括使用Covidence系统评价管理器从四个数据库的原始资料中提取数据。汇总数据表明,LITT可能是一种安全的主要治疗选择,在异柠檬酸脱氢酶(IDH)野生型多形性胶质母细胞瘤(GBM)和IDH突变型星形细胞瘤中的肿瘤消融率分别为94.8%和84.6%。对于IDH野生型GBM,汇总的PFS和OS分别为5.0个月和9.0个月。与先前文献报道的发生率相似,IDH野生型GBM的神经和非神经并发症发生率分别为10.3%和4.8%。IDH突变型星形细胞瘤队列中的神经和非神经并发症发生率略高,分别为33%和8.3%,这可能是由于队列规模较小所致。