Contemporary Applications of Laser Interstitial Thermal Therapy: A Comprehensive Systematic Review

Area of Science:

• Neurosurgery
• Minimally Invasive Procedures
• Neurology

Background:

• Laser interstitial thermal therapy (LITT) is a minimally invasive neurosurgical technique.
• It is increasingly recognized for treating intracranial pathologies, especially those in difficult-to-access locations.
• LITT offers a less invasive alternative to open surgery for specific neurological conditions.

Purpose of the Study:

• To systematically review the evidence supporting current applications of LITT.
• To evaluate the safety and efficacy of LITT across various intracranial pathologies.
• To consolidate findings on LITT's role in treating brain tumors, radiation necrosis, and epilepsy.

Main Methods:

• Systematic review adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
• Searched three databases for studies reporting primary data on LITT applications.
• Included 39 studies involving 1533 patients meeting predefined eligibility criteria.

Main Results:

• LITT demonstrated safety and efficacy in treating brain tumors, radiation necrosis (RN), mesial temporal lobe epilepsy (MTLE), and cavernous malformations.
• It is particularly beneficial for patients ineligible for craniotomy.
• Specific benefits include improved survival in glioblastomas (up to 26 months), faster steroid cessation in RN, and comparable seizure control in MTLE versus anterior temporal lobectomy.

Conclusions:

• LITT is a safe and effective treatment option for brain tumors, RN, and MTLE.
• It provides significant advantages over traditional treatments for selected patient populations.
• Further research into emerging LITT applications may expand its use for central nervous system pathologies.