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Stereotactic laser ablation in neuro-oncology - A survey among European neurosurgeons
Ilaria Viozzi1, Maroeska M Rovers2, Christiaan G Overduin2
1Department of Neurosurgery, Radboud University Medical Center, Radboud Institute for Health Sciences, 6525 GA, Nijmegen, The Netherlands.
Introduction:
In the last decades, the application of stereotactic laser ablation (SLA) for the treatment of intracranial tumours has been growing, even though comparative trials are lacking. Our aim was to investigate the familiarity with SLA of neurosurgeons in Europe and their opinion regarding potential neuro-oncological indications. Furthermore, we investigated treatment preferences and variability for three exemplar neuro-oncological cases and willingness to refer for SLA.
Material And Methods:
A 26-questions survey was mailed to members of the EANS neuro-oncology section. We presented three clinical cases of respectively deep-seated glioblastoma, recurrent metastasis and recurrent glioblastoma. Descriptive statistics was applied to report results.
Results:
110 respondents completed all questions. Recurrent glioblastoma and recurrent metastases were regarded as the most feasible indications for SLA (chosen by 69% and 58% of the respondents) followed by newly diagnosed high-grade gliomas (31%). Seventy percent of respondents would refer patients for SLA. The majority of respondents would consider SLA as a treatment option for all three presented cases: 79% for the deep-seated glioblastoma case, 65% for the recurrent metastasis case and 76% for the recurrent glioblastoma case. Among respondents who wouldn't consider SLA, preference for standard treatment and lack of clinical evidence were reported as the main reasons.
Conclusions:
Most of respondents considered SLA as a treatment option for recurrent glioblastoma, recurrent metastases and newly diagnosed deep-seated glioblastoma. At the moment the current evidence to support such a treatment is very low. Comparative prospective trials are needed to support the use of SLA and determine proper indications.
Insights
Neurosurgeons show interest in stereotactic laser ablation (SLA) for brain tumors, particularly recurrent glioblastoma and metastases. However, low current evidence necessitates comparative trials to establish definitive indications for this growing treatment.
Area of Science:
- Neurosurgery
- Oncology
- Medical Technology
Background:
- Stereotactic laser ablation (SLA) is increasingly used for intracranial tumors, but lacks comparative trial data.
- Understanding neurosurgeon familiarity and opinions on SLA is crucial for its clinical integration.
Purpose of the Study:
- To assess European neurosurgeons' familiarity with SLA for intracranial tumors.
- To evaluate their opinions on potential neuro-oncological indications for SLA.
- To investigate treatment preferences and referral willingness for specific neuro-oncological cases.
Main Methods:
- A 26-question survey was distributed to members of the EANS neuro-oncology section.
- Three clinical cases (deep-seated glioblastoma, recurrent metastasis, recurrent glioblastoma) were presented.
- Descriptive statistics were used to analyze the survey responses.
Main Results:
- 110 neurosurgeons completed the survey.
- Recurrent glioblastoma (69%) and recurrent metastases (58%) were most favored for SLA.
- 70% would refer patients for SLA, with majority considering it for all presented cases.
Conclusions:
- Neurosurgeons perceive SLA as a viable option for recurrent glioblastoma, metastases, and deep-seated gliomas.
- Current evidence supporting SLA is limited, highlighting the need for comparative prospective trials.
- Further research is required to define optimal indications and validate SLA's role in neuro-oncology.
