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. 2018 Oct 31:8:499.
doi: 10.3389/fonc.2018.00499. eCollection 2018.

Management of Intracranial Metastatic Disease With Laser Interstitial Thermal Therapy

Afshin Salehi  1 , Ashwin A Kamath  1 , Eric C Leuthardt  1 , Albert H Kim  1
Affiliations

Management of Intracranial Metastatic Disease With Laser Interstitial Thermal Therapy

Afshin Salehi et al. Front Oncol. .

Abstract

Treatment approaches for metastatic brain tumors continue to evolve, with increasing recent emphasis on focal therapies whenever possible. MRI-guided Laser Interstitial Thermal Therapy (LITT) is a minimally invasive surgical option that has broadened the capability of the neurosurgeon in treating difficult-to-treat intracranial lesions. This technology uses image-guided delivery of laser to the target lesion to generate heat and thereby ablate pathological tissue and has expanded the neurosurgical armamentarium for surgical treatment of brain metastases. In this study, we describe the indications for LITT in the management of intracranial metastatic disease and report our institutional experience with LITT.

Keywords: brain metastases; intracranial metastatic disease; laser interstitial thermal therapy (LITT); overall survival (OS); thermal-damage-threshold (TDT).

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Figures

Figure 1
Figure 1
(A) Kaplan-Meier graph of the overall survival (OS) of the population and the 95% confidence interval (CI). The median OS was 13.27 (95% CI = 9.83–23.20). (B) Shows the progression free survival (PFS) of the population and the 95% CI. The median PFS was 6.30 (95% CI = 5.3–17.43).
Figure 2
Figure 2
(A) Kaplan-Meier graph depicting the OS of patients with the group dichotomized based on the volume of tumors greater than 5.62 cm3 or less than and equal to 5.62 cm3. P-value for log rank test and hazard ratio are depicted on the graph. (B) Kaplan-Meier graph of PFS for patients with tumor volumes greater than 5.62 cm3 or less than and equal to 5.62 cm3. Log rank test comparing this two groups shows significantly improved survival for patients with smaller tumors (p = 0.024).
Figure 3
Figure 3
(A) Kaplan-Meier graph depicting the OS of patients with the group dichotomized based on the blue thermal dose threshold (TDT) coverage area of 97%. P-value for log rank test and hazard ratio are depicted on the graph. (B) Kaplan-Meier graph of PFS for patients with treatment coverage area greater than 97% or less than and equal to 97%. Log rank test comparing these two group shows a significantly improved survival for patients with blue TDT line coverage >97%.
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