Risk of Tract Seeding Following Laser Interstitial Thermal Therapy for Brain Tumors

Area of Science:

• Neurosurgery
• Oncology
• Medical Physics

Background:

• Intracranial oncological disease management is challenging.
• Laser interstitial thermal therapy (LITT) offers local control for brain tumors via photocoagulation.
• Increasing LITT use necessitates outcome characterization.

Purpose of the Study:

• Quantify the risk of tumor seeding along the laser fiber tract in patients undergoing LITT for brain tumors.
• Evaluate the incidence of tract seeding at a high-volume treatment center.

Main Methods:

• Retrospective review of LITT patients (2015-2021).
• Inclusion of patients with biopsy-confirmed tumors.
• Identification of tract seeding as new, discontinuous tumor enhancement along the LITT tract.

Main Results:

• Tract seeding occurred in 3 of 56 patients (5.4%).
• Seeding was associated with ablation from superficial tumor margins (P = .03).
• Patients with seeding had significantly shorter time to progression (1.1 months vs. 4.2 months, P = .03).

Conclusions:

• The risk of LITT tract seeding is low but associated with reduced progression-free survival.
• Surgical technique or experience may influence seeding risk.
• Post-LITT radiosurgery to the tract could potentially prevent seeding complications.