Glioblastoma Treated With Magnetic Resonance Imaging-Guided Laser Interstitial Thermal Therapy: Safety, Efficacy, and Outcomes.
Glioblastoma Treated With Magnetic Resonance Imaging-Guided Laser Interstitial Thermal Therapy: Safety, Efficacy, and Outcomes.
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DOI：
10.1093/neuros/nyy375
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发表时间：
2019-04-01
期刊：
影响因子：
4.8
通讯作者：
Leuthardt EC
中科院分区：
文献类型：
--
作者：
Kamath AA;Friedman DD;Akbari SHA;Kim AH;Tao Y;Luo J;Leuthardt EC
尽管有多种可用的治疗方法，但胶质母细胞瘤（GBM）仍然是一种侵袭性和均匀致命的肿瘤。激光间质热疗（LITT）是一种新型的微创治疗方法，有望治疗不适合传统开颅手术的GBM患者。然而，由于最近将LITT引入临床实践，缺乏评价LITT后安全性和长期结局的大型系列研究。介绍我们机构的50多例接受LITT治疗的GBM患者的安全性、疗效和结局。我们对经组织学证实的GBM患者进行了回顾性描述性研究。收集的数据包括人口统计学、肿瘤位置和体积、肿瘤遗传标记物、治疗体积、围手术期并发症和长期随访数据。我们对54例年龄超过5.5年的GBM患者进行了58次LITT治疗。41例为复发性肿瘤，17例为一线治疗。40例GBM位于脑叶，18例位于深部结构（丘脑、胼胝体、小脑）。平均肿瘤体积为12.5 ± 13.4 cm3。用黄色热损伤阈值（TDT）线（43°C持续2分钟的剂量当量）治疗的肿瘤的平均百分比为93.3% ± 10.6%，用蓝色TDT线（43°C持续10分钟的剂量当量）治疗的肿瘤的平均百分比为88.0% ± 14.2%。围手术期并发症7例（12%），死亡2例（3.4%）。总队列LITT后的中位总生存期为11.5个月，中位无进展生存期为6.6个月。在适当选择的患者中，LITT似乎是一种安全有效的GBM治疗方法。
Despite the multitude of available treatments, glioblastoma (GBM) remains an aggressive and uniformly fatal tumor. Laser interstitial thermal therapy (LITT) is a novel, minimally invasive treatment that holds promise for treating patients with GBM who are not candidates for traditional open craniotomy. However, due to the recent introduction of LITT into clinical practice, large series that evaluate safety and long-term outcomes after LITT are lacking. To present our institution's series of over 50 GBM patients treated with LITT, with regard to safety, efficacy, and outcomes. We performed a retrospective descriptive study of patients with histologically proven GBM who underwent LITT. Data collected included demographics, tumor location and volume, tumor genetic markers, treatment volume, perioperative complications, and long-term follow-up data. We performed 58 LITT treatments for GBM in 54 patients over 5.5 yr. Forty-one were recurrent tumors while 17 were frontline treatments. Forty GBMs were lobar in location, while 18 were in deep structures (thalamus, insula, corpus callosum). Average tumor volume was 12.5 ± 13.4 cm3. Average percentage of tumor treated with the yellow thermal damage threshold (TDT) line (dose equivalent of 43°C for 2 min) was 93.3% ± 10.6%, and with the blue TDT line (dose equivalent of 43°C for 10 min) was 88.0% ± 14.2%. There were 7 perioperative complications (12%) and 2 mortalities (3.4%). Median overall survival after LITT for the total cohort was 11.5 mo, and median progression-free survival 6.6 mo. LITT appears to be a safe and effective treatment for GBM in properly selected patients.
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影响因子：
158.5
作者：
Stupp, R;Mason, WP;Ryan, G
通讯作者：
Ryan, G
影响因子：
11.2
作者：
Man J;Shoemake JD;Ma T;Rizzo AE;Godley AR;Wu Q;Mohammadi AM;Bao S;Rich JN;Yu JS
通讯作者：
Yu JS
影响因子：
45.3
作者：
Hegi, Monika E.;Liu, Lili;Gilbert, Mark R.
通讯作者：
Gilbert, Mark R.
影响因子：
1.7
作者：
Kamath, Ashwin A.;Friedman, Daniel D.;Leuthardt, Eric C.
通讯作者：
Leuthardt, Eric C.
影响因子：
4.1
作者：
Dadey, David Y. A.;Kamath, Ashwin A.;Kim, Albert H.
通讯作者：
Kim, Albert H.