Sharma Eshita, Sahin Oguz Kagan, Łajczak Paweł, Rajab Numa, Ahmed Aisha Rizwan, Silva Yasmin Picanço, Bakhsh Ayesha, Chatterjee Anoushka, Raake Mohammed, Fagundes Walter
David Geffen School of Medicine at UCLA, Los Angeles, United States.
Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.
Neurochirurgie. 2025 Mar;71(2):101629. doi: 10.1016/j.neuchi.2025.101629. Epub 2025 Jan 3.
The confluence of laser interstitial thermal therapy (LITT) with immunotherapeutic approaches represents a promising option for managing recurrent brain lesions. However, the potential synergy between these modalities is still unclear. This meta-analysis examines the literature to elucidate the adverse effects and overall survival associated with this combination in treating recurrent brain metastases and glioblastoma.
Systematic searches were performed on PubMed, Embase, and Web of Science databases. Inclusion criteria comprised studies investigating the combined utilization of LITT with immunotherapy, among adult patients diagnosed with recurrent brain metastases and recurrent glioblastoma. Our analysis, using a random-effects model, pooled Overall Survival (OS) and Adverse events (AEs) from all the included studies.
We analyzed 162 patients from one RCT and three non-randomized studies. The pooled analysis of all patients revealed a median OS of 12.8 months (95% CI = 8.31-17.31; p < 0.01) with the combined treatment of LITT and immunotherapy. Similarly, approximately 6% of patients experienced AEs (95% CI = -0.01-0.11; p = 0.03). Subgroup analysis further demonstrated that among patients with recurrent glioma, the combined treatment showed pooled OS of 11 months (95% CI = 7.13-16.62; p < 0.01), while AEs were observed in 4% of patients (95% CI = -0.02-0.10; p = 0.21).
This meta-analysis showed a potentially comparable safety profile and overall survival to conventional treatment modalities. Further research is warranted to test differences in the incidence of AEs and OS from LITT with immunotherapy versus a control.
激光间质热疗(LITT)与免疫治疗方法的结合是治疗复发性脑损伤的一个有前景的选择。然而,这些治疗方式之间潜在的协同作用仍不明确。本荟萃分析通过研究文献来阐明这种联合治疗复发性脑转移瘤和胶质母细胞瘤的不良反应及总生存期。
对PubMed、Embase和Web of Science数据库进行系统检索。纳入标准包括对诊断为复发性脑转移瘤和复发性胶质母细胞瘤的成年患者中LITT与免疫治疗联合应用的研究。我们的分析采用随机效应模型,汇总了所有纳入研究的总生存期(OS)和不良事件(AE)。
我们分析了来自1项随机对照试验和3项非随机研究的162例患者。对所有患者的汇总分析显示,LITT与免疫治疗联合治疗的中位总生存期为12.8个月(95%CI = 8.31 - 17.31;p < 0.01)。同样,约6%的患者出现不良事件(95%CI = -0.01 - 0.11;p = 0.03)。亚组分析进一步表明,在复发性胶质瘤患者中,联合治疗的汇总总生存期为11个月(95%CI = 7.13 - 16.62;p < 0.01),而4%的患者出现不良事件(95%CI = -0.02 - 0.10;p = 0.21)。
本荟萃分析表明,与传统治疗方式相比,其安全性和总生存期可能具有可比性。有必要进一步研究以检验LITT联合免疫治疗与对照组在不良事件发生率和总生存期方面的差异。