Download PDF
CC BY-NC-ND 4.0 · Asian J Neurosurg 2020; 15(04): 800-808
DOI: 10.4103/ajns.AJNS_185_20
Review Article

Current role of laser interstitial thermal therapy in the treatment of intracranial tumors

Farhan Mirza
1   Department of Neurosurgery, The Montreal Neurological Institute, McGill University, Montreal, QC, Canada
2   Department of Neurosurgery, Kentucky Neuroscience Institute, University of Kentucky, Lexington, KY, USA
,
Rida Mitha
3   Department of Surgery, Section of Neurosurgery, The Aga Khan University Hospital, Karachi
,
Muhammad Shamim
3   Department of Surgery, Section of Neurosurgery, The Aga Khan University Hospital, Karachi
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Laser interstitial thermal therapy (LITT) is gaining popularity in the treatment of both primary and secondary intracranial tumors. The goal of LITT is to deliver thermal energy in a predictable, controlled, and minimally invasive fashion. It can be particularly valuable in patients with recurrent tumors who, due to previous radiation or surgery, may have a potentially higher risk of wound breakdown or infection with repeat craniotomy. Deep-seated lesions that are often inaccessible through open approaches (thalamus, hypothalamus, mesial basal temporal lobe, brainstem) may also be suitable targets. The experience and data published thus far on this modality is limited but growing. This review highlights the use of LITT as a primary treatment method in a variety of intracranial tumors, as well as its application as an adjunct to established surgical techniques.

Key-words:

Brain metastasis - brain tumor - laser ablation

Financial support and sponsorship

Nil.




Publication History

Received: 29 April 2020

Accepted: 24 July 2020

Article published online:
16 August 2022

© 2020. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Bown SG. Phototherapy in tumors. World J Surg 1983;7:700-9.
  • 2 Sugiyama K, Sakai T, Fujishima I, Ryu H, Uemura K, Yokoyama T. Stereotactic interstitial laser-hyperthermia using Nd-YAG laser. Stereotact Funct Neurosurg 1990;54-55:501-5.
  • 3 Bettag M, Ulrich F, Schober R, Furst G, Langen KJ, Sabel M, et al. Stereotactic laser therapy in cerebral gliomas. Acta Neurochir Suppl 1991;52:81-3.
  • 4 Schober R, Bettag M, Sabel M, Ulrich F, Hessel S. Fine structure of zonal changes in experimental Nd: YAG laser-induced interstitial hyperthermia. Lasers Surg Med 1993;13:234-41.
  • 5 Kahn T, Bettag M, Ulrich F, Schwarzmaier HJ, Schober R, Furst G, et al. MRI-guided laser-induced interstitial thermotherapy of cerebral neoplasms. J Comput Assist Tomogr 1994;18:519-32.
  • 6 Ascher PW, Justich E, Schrottner O. A new surgical but less invasive treatment of central brain tumours preliminary report. Acta Neurochir Suppl (Wien) 1991;52:78-80.
  • 7 Kahn T, Harth T, Bettag M, Schwabe B, Ulrich F, Schwarzmaier HJ, et al. Preliminary experience with the application of gadolinium-DTPA before MR imaging-guided laser-induced interstitial thermotherapy of brain tumors. J Manage Reson Imaging 1997;7:226-9.
  • 8 Kahn T, Harth T, Kiwit JC, Schwarzmaier HJ, Wald C, Modder U. In vivo MRI thermometry using a phase-sensitive sequence: Preliminary experience during MRI-guided laser-induced interstitial thermotherapy of brain tumors. J Manage Reson Imaging 1998;8:160-4.
  • 9 Schwabe B, Kahn T, Harth T, Ulrich F, Schwarzmaier HJ. Laser-induced thermal lesions in the human brain: Short- and long-term appearance on MRI. J Comput Assist Tomogr 1997;21:818-25.
  • 10 Reimer P, Bremer C, Horch C, Morgenroth C, Allkemper T, Schuierer G. MR-monitored LITT as a palliative concept in patients with high grade gliomas: Preliminary clinical experience. J Magn Reson Imaging 1998;8:240-4.
  • 11 Schwarzmaier HJ, Eickmeyer F, von Tempelhoff W, Fiedler VU, Niehoff H, Ulrich SD, et al. MR-guided laser-induced interstitial thermotherapy of recurrent glioblastoma multiforme: Preliminary results in 16 patients. Eur J Radiol 2006;59:208-15.
  • 12 McNichols RJ, Gowda A, Kangasniemi M, Bankson JA, Price RE, Hazle JD. MR thermometry-based feedback control of laser interstitial thermal therapy at 980 nm. Lasers Surg Med 2004;34:48-55.
  • 13 Sharma M, Balasubramanian S, Silva D, Barnett GH, Mohammadi AM. Laser interstitial thermal therapy in the management of brain metastasis and radiation necrosis after radiosurgery: An overview. Expert Rev Neurother 2016;16:223-32.
  • 14 Silva D, Sharma M, Barnett GH. Laser ablation vs. open resection for deep-seated tumors: Evidence for laser ablation. Neurosurgery 2016;63 Suppl 1:15-26.
  • 15 Lee I, Kalkanis S, Hadjipanayis CG. Stereotactic laser interstitial thermal therapy for recurrent high-grade gliomas. Neurosurgery 2016;79 Suppl 1:S24-34.
  • 16 Lamborn KR, Yung WK, Chang SM, Wen PY, Cloughesy TF, DeAngelis LM, et al. Progression-free survival: An important end point in evaluating therapy for recurrent high-grade gliomas. Neuro Oncol 2008;10:162-70.
  • 17 Mirza FA, Shamim MS. Tumour Treating Fields (TTFs) for recurrent and newly diagnosed glioblastoma multiforme. J Pak Med Assoc 2018;68:1543-5.
  • 18 Han SJ, Chang SM, Berger MS. Laser ablation vs. open resection for deep-seated tumors: The case for open resection. Neurosurgery 2016;63 Suppl 1:10-4.
  • 19 Leonardi MA, Lumenta CB. Stereotactic guided laser-induced interstitial thermotherapy (SLITT) in gliomas with intraoperative morphologic monitoring in an open MR: Clinical expierence. Minim Invasive Neurosurg 2002;45:201-7.
  • 20 Schwarzmaier HJ, Eickmeyer F, von Tempelhoff W, Fiedler VU, Niehoff H, Ulrich SD, et al. MR-guided laser irradiation of recurrent glioblastomas. J Magn Reson Imaging 2005;22:799-803.
  • 21 Jethwa PR, Barrese JC, Gowda A, Shetty A, Danish SF. Magnetic resonance thermometry-guided laser-induced thermal therapy for intracranial neoplasms: Initial experience. Neurosurgery 2012;71:133-44.
  • 22 Carpentier A, Chauvet D, Reina V, Beccaria K, Leclerq D, McNichols RJ, et al. MR-guided laser-induced thermal therapy (LITT) for recurrent glioblastomas. Lasers Surg Med 2012;44:361-8.
  • 23 Sloan AE, Ahluwalia MS, Valerio-Pascua J, Manjila S, Torchia MG, Jones SE, et al. Results of the NeuroBlate System first-in-humans Phase I clinical trial for recurrent glioblastoma. J Neurosurg 2013;118:1202-19.
  • 24 Hawasli AH, Bagade S, Shimony JS, Miller-Thomas M, Leuthardt EC. Magnetic resonance imaging-guided focused laser interstitial thermal therapy for intracranial lesions: Single-institution series. Neurosurgery 2013;73:1007-17.
  • 25 Mohammadi AM, Hawasli AH, Rodriguez A, Schroeder JL, Laxton AW, Elson P, et al. The role of laser interstitial thermal therapy in enhancing progression-free survival of difficult-to-access high-grade gliomas: A multicenter study. Cancer Med 2014;3:971-9.
  • 26 Leuthardt EC, Duan C, Kim MJ, Campian JL, Kim AH, Miller-Thomas MM, et al. Hyperthermic laser ablation of recurrent glioblastoma leads to temporary disruption of the peritumoral blood brain barrier. PLoS One 2016;11:e0148613.
  • 27 Thomas JG, Rao G, Kew Y, Prabhu SS. Laser interstitial thermal therapy for newly diagnosed and recurrent glioblastoma. Neurosurg Focus 2016;41:E12.
  • 28 Barnett GH, Voigt JD, Alhuwalia MS. A systematic review and meta-analysis of studies examining the use of brain laser interstitial thermal therapy versus craniotomy for the treatment of high-grade tumors in or near areas of eloquence: An examination of the extent of resection and major complication rates associated with each type of surgery. Stereotact Funct Neurosurg 2016;94:164-73.
  • 29 Mohammadi AM, Sharma M, Beaumont TL, Juarez KO, Kemeny H, Dechant C, et al. Upfront magnetic resonance imaging-guided stereotactic laser-ablation in newly diagnosed glioblastoma: A multicenter review of survival outcomes compared to a matched cohort of biopsy-only patients. Neurosurgery 2019;85:762-72.
  • 30 Patchell RA, Tibbs PA, Regine WF, Dempsey RJ, Mohiuddin M, Kryscio RJ, et al. Postoperative radiotherapy in the treatment of single metastases to the brain: A randomized trial. JAMA 1998;280:1485-9.
  • 31 Laghari AA, Ahmed SI, Shamim MS. Role of surgery in brain metastases. J Pak Med Assoc 2017;67:1299-300.
  • 32 Carpentier A, McNichols RJ, Stafford RJ, Itzcovitz J, Guichard JP, Reizine D, et al. Real-time magnetic resonance-guided laser thermal therapy for focal metastatic brain tumors. Neurosurgery 2008;63:ONS21-8.
  • 33 Carpentier A, McNichols RJ, Stafford RJ, Guichard JP, Reizine D, Delaloge S, et al. Laser thermal therapy: Real-time MRI-guided and computer-controlled procedures for metastatic brain tumors. Lasers Surg Med 2011;43:943-50.
  • 34 Chaunzwa TL, Deng D, Leuthardt EC, Tatter SB, Mohammadi AM, Barnett GH, et al. Laser thermal ablation for metastases failing radiosurgery: A multicentered retrospective study. Neurosurgery 2018;82:56-63.
  • 35 Ali MA, Carroll KT, Rennert RC, Hamelin T, Chang L, Lemkuil BP, et al. Stereotactic laser ablation as treatment for brain metastases that recur after stereotactic radiosurgery: A multi-institutional experience. Neurosurg Focus 2016;41:E11.
  • 36 Kotecha R, Damico N, Miller JA, Suh JH, Murphy ES, Reddy CA, et al. Three or more courses of stereotactic radiosurgery for patients with multiply recurrent brain metastases. Neurosurgery 2017;80:871-9.
  • 37 Williamson R, Kondziolka D, Kanaan H, Lunsford LD, Flickinger JC. Adverse radiation effects after radiosurgery may benefit from oral vitamin E and pentoxifylline therapy: A pilot study. Stereotact Funct Neurosurg 2008;86:359-66.
  • 38 Low-dose Intra-arterial Bevacizumab for Edema and Radiation Necrosis Therapeutic Intervention (LIBERTI); 2016. Available from: https://clinicaltrials.gov/ct2/show/NCT02819479.Identificationnumber: NCT02819479. [Last accessed on 2020 Aug 10].
  • 39 Rahmathulla G, Recinos PF, Valerio JE, Chao S, Barnett GH. Laser interstitial thermal therapy for focal cerebral radiation necrosis: A case report and literature review. Stereotact Funct Neurosurg 2012;90:192-200.
  • 40 Rao MS, Hargreaves EL, Khan AJ, Haffty BG, Danish SF. Magnetic resonance-guided laser ablation improves local control for postradiosurgery recurrence and/or radiation necrosis. Neurosurgery 2014;74:658-67.
  • 41 Smith CJ, Myers CS, Chapple KM, Smith KA. Long-Term follow-up of 25 cases of biopsy-proven radiation necrosis or post-radiation treatment effect treated with magnetic resonance-guided laser interstitial thermal therapy. Neurosurgery 2016;79 Suppl 1:S59-72.
  • 42 Ahluwalia M, Barnett GH, Deng D, Tatter SB, Laxton AW, Mohammadi AM, et al. Laser ablation after stereotactic radiosurgery: A multicenter prospective study in patients with metastatic brain tumors and radiation necrosis. J Neurosurg 2018;130:804-11.
  • 43 Ivan ME, Diaz RJ, Berger MH, Basil GW, Osiason DA, Plate T, et al. Magnetic Resonance-guided laser ablation for the treatment of recurrent dural-based lesions: A series of five cases. World Neurosurg 2017;98:162-70.
  • 44 Tovar-Spinoza Z, Choi H. Magnetic resonance-guided laser interstitial thermal therapy: Report of a series of pediatric brain tumors. J Neurosurg Pediatr 2016;17:723-33.
  • 45 Riordan M, Tovar-Spinoza Z. Laser induced thermal therapy (LITT) for pediatric brain tumors: Case-based review. Transl Pediatr 2014;3:229-35.
  • 46 Dadey DY, Kamath AA, Leuthardt EC, Smyth MD. Laser interstitial thermal therapy for subependymal giant cell astrocytoma: Technical case report. Neurosurg Focus 2016;41:E9.
  • 47 Patel NV, Agarwal N, Mammis A, Danish SF. Frameless stereotactic magnetic resonance imaging-guided laser interstitial thermal therapy to perform bilateral anterior cingulotomy for intractable pain: Feasibility, technical aspects, and initial experience in 3 patients. Oper Neurosurg (Hagerstown) 2015;11 Suppl 2:17-25.
  • 48 Galgano M, Fridley J, Oyelese A, Telfian A, Kosztowski T, Choi D, et al. Surgical management of spinal metastases. Expert Rev Anticancer Ther 2018;18:463-72.
  • 49 Tatsui CE, Stafford RJ, Li J, Sellin JN, Amini B, Rao G, et al. Utilization of laser interstitial thermotherapy guided by real-time thermal MRI as an alternative to separation surgery in the management of spinal metastasis. J Neurosurg Spine 2015;23:400-11.
  • 50 Youngerman BE, Save AV, McKhann GM. Magnetic resonance imaging-guided laser interstitial thermal therapy for epilepsy: Systematic review of technique, indications, and outcomes. Neurosurgery 2020;86:E366-82.
  • 51 Curry DJ, Gowda A, McNichols RJ, Wilfong AA. MR-guided stereotactic laser ablation of epileptogenic foci in children. Epilepsy Behav 2012;24:408-14.
  • 52 Kuo CH, Feroze AH, Poliachik SL, Hauptman JS, Novotny EJ Jr, Ojemann JG. Laser ablation therapy for pediatric patients with intracranial lesions in eloquent areas. World Neurosurg 2019;121:e191-9.
  • 53 Easwaran TP, Lion A, Vortmeyer AO, Kingery K, Bc M, Raskin JS. Seizure freedom from recurrent insular low-grade glioma following laser interstitial thermal therapy. Childs Nerv Syst 2020;36:1055-9.
  • 54 Pisipati S, Smith KA, Shah K, Ebersole K, Chamoun RB, Camarata PJ. Intracerebral laser interstitial thermal therapy followed by tumor resection to minimize cerebral edema. Neurosurg Focus 2016;41:E13.
  • 55 Wright J, Chugh J, Wright CH, Alonso F, Hdeib A, Gittleman H, et al. Laser interstitial thermal therapy followed by minimal-access transsulcal resection for the treatment of large and difficult to access brain tumors. Neurosurg Focus 2016;41:E14.
  • 56 Khan I, Waqas M, Shamim MS. Prognostic significance of IDH 1 mutation in patients with glioblastoma multiforme. J Pak Med Assoc 2017;67:816-7.
  • 57 Laser Interstitial Thermal Therapy (LITT) for the Treatment of Pediatric Central Nervous System Tumors; 2015. Available from: https://clinicaltrials.gov/ct2/show/NCT02451215.Identificationnumber: NCT02451215. [Last accessed on 2020 Aug 10].
  • 58 MRI-Guided LITT for Treatment Metastatic Brain Tumors; 2014. Available from: https://clinicaltrials.gov/ct2/show/study/NCT01736722.Identificationnumber: NCT01736722. [Last accessed on 2020 Aug 10].
  • 59 Voigt JD, Barnett G. The value of using a brain laser interstitial thermal therapy (LITT) system in patients presenting with high grade gliomas where maximal safe resection may not be feasible. Cost Eff Resour Alloc 2016;14:6.
  • 60 Kim AH, Tatter S, Rao G, Prabhu S, Chen C, Fecci P, et al. Laser ablation of abnormal neurological tissue using robotic neuroblate system (LAANTERN): 12-month outcomes and quality of life after brain tumor ablation. Neurosurgery 2020. pii: nyaa071.