1. Safety and Efficacy of Laser Interstitial Thermal Therapy as Upfront Therapy in Primary Glioblastoma and IDH-Mutant Astrocytoma: A Meta-Analysis.
- Author
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Pandey, Aryan, Chandla, Anubhav, Mekonnen, Mahlet, Hovis, Gabrielle E. A., Teton, Zoe E., Patel, Kunal S., Everson, Richard G., Wadehra, Madhuri, and Yang, Isaac
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PROTEIN metabolism , *MEDICAL information storage & retrieval systems , *PATIENT safety , *GLIOMAS , *MOLECULAR probes , *IMMUNOTHERAPY , *TREATMENT effectiveness , *META-analysis , *LASER therapy , *SYSTEMATIC reviews , *MEDLINE , *METASTASIS , *OXIDOREDUCTASES , *MEDICAL databases , *MENINGIOMA , *GENETIC mutation , *ONLINE information services , *PROGRESSION-free survival , *BRAIN tumors , *OVERALL survival - Abstract
Simple Summary: Laser interstitial thermal therapy (LITT) is a minimally invasive, MRI-guided procedure that causes localized tissue hyperthermia. This results in the ablation of targeted cells and disruption of the blood–brain barrier. LITT offers an alternative treatment option to standard-of-care resection for glioma in addition to potentially enhancing drug delivery of adjuvant therapy. Here, we present the first meta-analysis since the fifth edition of the WHO Classification of Tumors of the Central Nervous System (WHO CNS5) to assess the current literature on the safety and efficacy of LITT in the upfront treatment of primary brain tumors. This study summarizes the current relevant literature on LITT and supports its viability as a treatment option for glioblastoma and IDH-mutant astrocytoma. 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. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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