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. 2022 Sep 9:17:100136.
doi: 10.1016/j.wnsx.2022.100136. eCollection 2023 Jan.

LITTing up Gliomas-Is the Future Bright?

Philip J O'Halloran  1   2   3 , Jack Henry  4 , Michael Amoo  4 , Aristotelis Kalyvas  1 , Nilesh Mohan  1 , Gelareh Zadeh  1 , Suneil K Kalia  1 , Paul N Kongkham  1
Affiliations

LITTing up Gliomas-Is the Future Bright?

Philip J O'Halloran et al. World Neurosurg X. .

Abstract

Background: Laser interstitial thermal therapy (LITT) represents an attractive therapeutic strategy for several intracranial pathologies; however, there is a paucity of literature regarding its efficacy for the treatment of gliomas.

Methods: MEDLINE, EMBASE, Scopus, and Web of Science were searched from inception until March 19, 2021. Studies specifically relating to the use of LITT in treatment of glioma were eligible for inclusion. A meta-analysis of means was performed to assess the progression-free survival (PFS) and overall survival (OS) following LITT and descriptive statistics relating to patients undergoing LITT were collated and a meta-analysis of proportions was also performed to assess the rate of complications.

Results: In total, 17 studies were included for the meta-analysis, comprising 401 patients with 408 gliomas of which 88 of 306 (28.8%) were grade 1 or 2 and 218 of 306 (71.2%) were grade 3 or 4. Of these, 256 of 408 (62.8%) were primary presentation and 152 of 408 (37.2%) were recurrent. The pooled mean OS was 13.58 months (95% confidence interval [CI] 9.77-17.39) and the PFS was 4.96 months (95% CI 4.19-5.72). The OS and PFS of recurrent glioblastoma were 12.4 months (95% CI 9.61-16.18) and 4.84 months (95% CI 0.23-9.45), respectively. Complications occurred in 114 of 411 (24%; 95% CI 14-41), of which 44 (11%) were transient deficits.

Conclusions: There is an increasing body of evidence demonstrating the use of LITT in the surgical management of deep-seated gliomas in patients of poor performance status. However, further studies are required to interrogate the clinical effectiveness of LITT in the setting of gliomas as well as assessing the survival benefit versus standard treatment alone.

Keywords: CI, Confidence interval; Glioma; LITT; LITT, Laser interstitial thermal therapy; Laser ablation; Laser interstitial thermocoagulation therapy; OS, Overall survival; PFS, Progression-free survival.

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Conflict of interest statement

The authors declare that the article content was composed in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram detailing article screening and selection.
Figure 2
Figure 2
(A) Donut chart detailing the number of high-grade (grade 3 or 4) versus low-grade (grade 1 or 2) gliomas included. (B) Donut chart detailing the number of primary versus secondary gliomas included. (C) Bar chart detailing the locations of included gliomas. (D) Bar chart detailing the types and number of complications of laser interstitial thermal therapy observed.
Figure 3
Figure 3
Forest plots for each analysis. (A) Complication rate, (B) overall survival, and (C) progression-free survival.
Figure 4
Figure 4
Forest plots showing the results of a subgroup analysis assessing recurrent glioblastomas (rGBMs). (A) Overall survival (OS) and (B) progression-free survival (PFS).
Figure 5
Figure 5
Funnel plots for each analysis. (A) Complications, (B) overall survival, and (C) progression-free survival.
See this image and copyright information in PMC

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