An analysis of functional outcomes following laser interstitial thermal therapy for recurrent high-grade glioma.

IF 4.3 3区 材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC
Bradley Wilhelmy, Riccardo Serra, Chixiang Chen, Mark Mishra, Dario Rodrigues, Neeraj Badjatia, Melissa Motta, Alexander Ksendzovsky, Graeme F Woodworth
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Abstract

Objective: Laser interstitial thermal therapy (LITT) is an emerging tool for treating a variety of focal brain lesions, including recurrent high-grade glioma (HGG). While the efficacy and uses of LITT have been well studied, the impact of this treatment on patient functional outcomes has not been analyzed in detail. This study sought to better define the role of LITT in treating patients with recurrent HGG, examining which patients exhibit good functional outcomes after LITT, and to determine risk factors for worsening neurological function.

Methods: The medical records of patients treated with LITT for recurrent HGG at a single tertiary care center were retrospectively reviewed. Functional status was assessed using the Karnofsky Performance Scale (KPS). Demographic, clinical, and radiological data were examined for associations with change in KPS score assessed 4-6 weeks following surgery.

Results: Forty-seven patients were included in the study with histopathologically confirmed recurrent HGG. The mean age was 57 years, and 21 (45%) patients were female. The pre-LITT KPS scores were as follows: 100 in 4 (9%) patients, 90 in 15 (32%) patients, 80 in 10 (21%) patients, 70 in 13 (28%) patients, and 60 in 5 (11%) patients. Overall, 59% of patients showed a stable or improved KPS score after undergoing LITT. Tumor volume was the sole predictor of decreased KPS score after LITT. Notably, tumor location including eloquent location, preoperative KPS score, and other comorbidities were not independently associated with change in functional status.

Conclusions: The majority of patients undergoing LITT for recurrent HGG had a favorable functional outcome at the initial follow-up visit. The treated tumor volume was inversely and independently associated with post-LITT functional outcome. This information may help guide patient selection and treatment optimization in the setting of LITT-based approaches for recurrent HGG.

激光间质热疗治疗复发性高级别胶质瘤后的功能效果分析。
目的:激光间质热疗(LITT)是治疗包括复发性高级别胶质瘤(HGG)在内的各种脑部病灶的新兴手段。虽然对 LITT 的疗效和用途进行了深入研究,但尚未详细分析这种治疗方法对患者功能预后的影响。本研究旨在更好地界定LITT在治疗复发性HGG患者中的作用,研究哪些患者在LITT后表现出良好的功能预后,并确定神经功能恶化的风险因素:方法:对一家三级医疗中心接受LITT治疗的复发性HGG患者的病历进行回顾性分析。采用卡诺夫斯基表现量表(KPS)评估患者的功能状态。研究了人口统计学、临床和放射学数据与术后4-6周KPS评分变化的关系:研究共纳入47例经组织病理学证实的复发性HGG患者。平均年龄为 57 岁,21 名(45%)患者为女性。LITT 前的 KPS 评分如下:4 名患者(9%)的 KPS 评分为 100 分,15 名患者(32%)的 KPS 评分为 90 分,10 名患者(21%)的 KPS 评分为 80 分,13 名患者(28%)的 KPS 评分为 70 分,5 名患者(11%)的 KPS 评分为 60 分。总体而言,59%的患者在接受 LITT 治疗后 KPS 评分趋于稳定或有所提高。肿瘤体积是 LITT 后 KPS 评分下降的唯一预测因素。值得注意的是,肿瘤位置(包括颅骨位置)、术前KPS评分和其他合并症与功能状态的变化并无独立关联:结论:大多数接受LITT治疗复发性HGG的患者在首次随访时功能状况良好。接受治疗的肿瘤体积与LITT后的功能预后呈独立的反比关系。这些信息有助于指导复发性HGG患者在接受LITT治疗时的患者选择和治疗优化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.20
自引率
4.30%
发文量
567
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