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John de Groot, Albert Kim, Sujit Prabhu, Ganesh Rao, Adrian Laxton, Peter Fecci, Barbara O'Brien, Andrew Sloan, Veronica Chiang, Stephen Tatter, Alireza Mohammadi, Dimitris Placantonakis, Roy Strowd, Clark Chen, Constantinos Hadjipanayis, Mustafa Khasraw, David Sun, David Piccioni, Kaylyn Sinicrope, Jian Campian, Sylvia Kurz, Brian Williams, Kris Smith, Zulma Tovar-Spinoza, Eric Leuthardt, SURG-23. EFFICACY OF LASER INTERSTITIAL THERMAL THERAPY (LITT) FOR NEWLY DIAGNOSED AND RECURRENT IDH WILD-TYPE GLIOBLASTOMA, Neuro-Oncology, Volume 24, Issue Supplement_7, November 2022, Pages vii256–vii257, https://doi.org/10.1093/neuonc/noac209.989
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Abstract
Treatment options for glioblastoma remain limited, particularly for those who are not eligible for traditional resection, whether due to lesion location or inability to tolerate open craniotomy. Maximal-safe resection followed by radiation with concurrent and adjuvant temozolomide offers the best outcomes for patients. Unfortunately, not all tumors are amenable to conventional surgical resection at the time of diagnosis with only about 1/3 of patients able to receive a gross-total resection and 15-25% of patients receiving biopsy only, thus reducing their projected overall survival to 9 months. Laser interstitial thermal therapy (LITT) is a minimally invasive, cytoreductive tool, that has demonstrated safety as a surgical approach to treat primary brain tumors.
Data from LAANTERN prospective multicenter registry (NCT02392078) was analyzed to determine clinical outcomes for patients with new and recurrent IDH wild-type glioblastoma (N=89). Demographics, intraprocedural data, adverse events, KPS, health-economics, and survival data were prospectively collected then analyzed separately for newly diagnosed GBM (N=29) and recurrent GBM (N=60).
Median overall-survival was 9.73 months (95% CI: 5.16, 15.91) for newly diagnosed patients and median post-procedure survival was 8.97 (6.94, 12.36) months for recurrent patients. Median overall-survival for newly diagnosed patients receiving post-LITT chemoradiotherapy was 16.14 months (6.11, not reached). The median length of hospital stay was 50 hours and 80% of patients were discharged to home.
LITT offers an effective cytoreductive approach for patients with newly diagnosed and recurrent IDH wild-type glioblastoma. Importantly, its use in newly diagnosed patients who receive post-LITT chemoradiotherapy leads to a median OS similar to that of patients treated with conventional surgical resection. LITT remains an important alternative for patients with inoperable tumors or those not amenable to resection. Enrollment in LAANTERN is ongoing and these cohorts will be revisited as data continues to mature. Benefits beyond cytoreduction are also being actively explored.
- surgical procedures, minimally invasive
- biopsy
- debulking
- glioblastoma
- immunologic adjuvants
- pharmaceutical adjuvants
- craniotomy
- demography
- medical economics
- lasers
- length of stay
- safety
- surgical procedures, operative
- diagnosis
- neoplasms
- treatment outcome
- temozolomide
- primary brain tumors
- radiochemotherapy
- laser ablation
- excision
- adverse event