Laser interstitial thermal therapy for IDH wild-type recurrent glioblastoma: a Scandinavian two-center cohort study

Management of recurrent glioblastoma (rGBM) remains challenging, particularly for deep-seated or eloquent recurrences not amenable to open surgery, and no standardized effective treatment exists for recurrent disease. European data on MR-guided laser interstitial thermal therapy (LITT) are scarce. This study presents the first Scandinavian experience with LITT for IDH-wild-type rGBM, within publicly funded healthcare systems providing population-wide access to care.

Retrospective data from 30 consecutive patients with histologically confirmed IDH-wild-type rGBM treated with LITT at two Scandinavian centers between January 2019 and May 2024 were analyzed. Demographics, ECOG performance status, procedural parameters, adverse events, and survival outcomes were collected. Kaplan-Meier estimates were used for progression-free survival (PFS) and overall survival (OS).

Mean age was 57 years (SD 10.2); 83% had pre-LITT ECOG 0. Complete and ≥ 90% ablation of contrast enhancement was achieved in 83% and 97% of cases, respectively. Median hospital stay was 1 day, with 87% discharged by day 2. Adverse events occurred in 33%, predominantly transient neurological deficits (27%) and infections (7%); 10% had persistent deficits. Median OS after LITT was 13.5 months (95% CI 11.6-20.5) and median PFS was 4.3 months (95% CI 2.6-9.1); 37% remained progression-free at 6 months.

LITT was feasible and well tolerated in this two-center Scandinavian cohort, with short hospitalization and low morbidity. Survival outcomes were within the range reported in previous international series. While these findings provide preliminary real-world data on LITT use within Scandinavian publicly funded healthcare systems, the limited sample size and retrospective design preclude definitive conclusions. Prospective, controlled studies are warranted to clarify the clinical role of LITT in recurrent glioblastoma.