Yang Bowen, Zhang Chao, Wang Xiu, Zhao Baotian, Mo Jiajie, Luo Weiyuan, Shao Xiaoqiu, Zhang Jianguo, Zhang Kai, Hu Wenhan
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Stereotactic and Functional Neurosurgery Laboratory, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
Ann Clin Transl Neurol. 2025 Jan;12(1):110-120. doi: 10.1002/acn3.52258. Epub 2024 Dec 3.
This study assessed the efficacy and safety of magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) versus open surgery (OS) for the treatment of patients with bottom-of-sulcus dysplasia (BOSD)-related epilepsy.
Twenty-two patients underwent MRgLITT, while 39 underwent OS. Postoperative seizure-free rates were analyzed using Kaplan-Meier curves. The removal ratio, which represents the extent of damage, was calculated based on preoperative lesion volume and postoperative removal volume. Other outcomes, including adverse events, operative time, and hospital stay, were also compared.
Kaplan-Meier curves indicated the seizure-free rates were comparable between the MRgLITT group (90.9%, 26.5 [23.0, 35.1] months) and OS group (89.7%, 25.2 [16.2, 34.6] months) at the final follow-up (p = 0.901, log-rank test). The removal ratio of MRgLITT (1.3 [1.1, 1.7]) was significantly lower (p = 0.007) than that of OS (5.8 [3.6, 8.5]). A comparison of postoperative neurological deficits, infection rates, and fever rates revealed no significant differences between MRgLITT and OS groups. The operative time (hours) of MRgLITT (3.0, [2.1, 4.9]) was significantly shorter (p = 0.007) than that of OS (3.5 [3.0, 4.5]). The hospital stay (days) after MRgLITT (6 [5.0, 7.5]) was significantly shorter (p < 0.001) than that of OS (11.0 [9.0, 13.5]).
MRgLITT has advantages over OS, including comparable seizure control and adverse event profiles, along with reduced removal ratios, shorter operative time, and shorter hospital stays.
本研究评估磁共振引导激光间质热疗（MRgLITT）与开放手术（OS）治疗脑沟底部发育异常（BOSD）相关癫痫患者的疗效和安全性。
22例患者接受了MRgLITT治疗，39例患者接受了开放手术。使用Kaplan-Meier曲线分析术后无癫痫发作率。根据术前病变体积和术后切除体积计算代表损伤程度的切除率。还比较了其他结果，包括不良事件、手术时间和住院时间。
Kaplan-Meier曲线表明，在最终随访时，MRgLITT组（90.9%，26.5[23.0,35.1]个月）和开放手术组（89.7%，25.2[16.2,34.6]个月）的无癫痫发作率相当（p = 0.901，对数秩检验）。MRgLITT的切除率（1.3[1.1,1.7]）显著低于开放手术（5.8[3.6,8.5]）（p = 0.007）。对术后神经功能缺损、感染率和发热率的比较显示，MRgLITT组和开放手术组之间无显著差异。MRgLITT的手术时间（小时）（3.0，[2.1,4.9]）显著短于开放手术（3.5[3.0,4.5]）（p = 0.007）。MRgLITT后的住院时间（天）（6[5.0,7.5]）显著短于开放手术（11.0[9.0,13.5]）（p < 0.001）。
MRgLITT相对于开放手术具有优势，包括相当的癫痫控制和不良事件情况，以及更低的切除率、更短的手术时间和更短的住院时间。
