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LITTing up Gliomas-Is the Future Bright?
Philip J O'Halloran1,2,3, Jack Henry4, Michael Amoo4
1Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Ontario, Canada.
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.
Insights
Laser interstitial thermal therapy (LITT) shows potential for glioma treatment, with a pooled overall survival of 13.58 months and progression-free survival of 4.96 months. Complications occurred in 24% of patients.
Area of Science:
- Neurosurgery
- Oncology
- Medical Technology
Background:
- Laser interstitial thermal therapy (LITT) is a promising treatment for intracranial pathologies.
- Limited literature exists on LITT's efficacy for treating gliomas.
Purpose of the Study:
- To evaluate the efficacy of LITT in glioma treatment.
- To assess survival outcomes and complication rates associated with LITT for gliomas.
Main Methods:
- A systematic review and meta-analysis of studies published until March 19, 2021.
- Searched MEDLINE, EMBASE, Scopus, and Web of Science for LITT glioma treatment studies.
- Analyzed progression-free survival (PFS), overall survival (OS), and complication rates.
Main Results:
- 17 studies with 401 patients and 408 gliomas were included.
- Pooled mean OS was 13.58 months; pooled mean PFS was 4.96 months.
- Complications occurred in 24% of patients, with 11% being transient deficits.
Conclusions:
- LITT is increasingly used for deep-seated gliomas in patients with poor performance status.
- Further research is needed to confirm LITT's clinical effectiveness and survival benefits compared to standard treatments for gliomas.
