Adham M Khalafallah, Khushi H Shah, Maxon V Knott, Chandler N Berke, Ashish H Shah, Ricardo J Komotar, Michael E Ivan
{"title":"Evaluating laser interstitial thermal therapy for newly diagnosed, deep-seated, large-volume glioblastoma: survival and outcome analysis.","authors":"Adham M Khalafallah, Khushi H Shah, Maxon V Knott, Chandler N Berke, Ashish H Shah, Ricardo J Komotar, Michael E Ivan","doi":"10.3171/2024.8.FOCUS24457","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Laser interstitial thermal therapy (LITT) has emerged as an alternative for treating glioblastoma (GBM) in patients deemed unsuitable for resection due to deep-seated or eloquent location, age, or comorbidities. However, its safety and efficacy in large-volume, deep-seated, newly diagnosed GBM (nGBM) tumors remain insufficiently studied. Therefore, the authors aimed to assess the outcomes of LITT in the treatment of deep-seated, large-volume nGBM.</p><p><strong>Methods: </strong>A retrospective analysis of patients with nGBM who underwent LITT between February 2013 and August 2023 was conducted. Patients with deep-seated tumor volume ≥ 10 cm3 treated with LITT were compared to patients with deep-seated tumor volume < 10 cm3. Demographic, perioperative, and follow-up data were collected and compared among both groups. Kaplan-Meier survival analysis and Cox proportional hazards regression were performed to evaluate the impact of various clinical and treatment-related factors on patient survival.</p><p><strong>Results: </strong>A total of 33 patients in the study group (mean ± SD age 65.7 ± 10.2 years, 58% male) with mean tumor volume 36.0 ± 21.6 cm3 were compared to 23 controls (mean age 67.0 ± 12.5 years, 61% male) with mean tumor volume 5.2 ± 2.7 cm3. There were no significant differences in hospital length of stay (p = 0.494), temporary neurological deficits and edema within 30 days (p = 0.705 and p > 0.999, respectively), 30-day readmissions (p = 0.139), < 30-day complications (p = 0.918), complications between 30 days and 3 months (p = 0.903), and new motor and speech deficits within 3 months (p = 0.883 and p > 0.999, respectively) between the study and control groups. Kaplan-Meier analysis did not reveal any statistically significant difference in overall survival (OS) between groups (p = 0.227). Multivariate analysis indicated that tumor volume did not significantly affect the hazard ratio for individuals undergoing LITT (HR 1.16, 95% CI 0.83-3.29, p = 0.150).</p><p><strong>Conclusions: </strong>This pilot study suggests that LITT is safe for treating patients with large-volume, deep-seated nGBM compared to those with small-volume tumor. Although there appears to be improved OS in patients with smaller lesions with greater EOA, significance was not achieved in this cohort.</p>","PeriodicalId":3,"journal":{"name":"ACS Applied Electronic Materials","volume":null,"pages":null},"PeriodicalIF":4.3000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"ACS Applied Electronic Materials","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3171/2024.8.FOCUS24457","RegionNum":3,"RegionCategory":"材料科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENGINEERING, ELECTRICAL & ELECTRONIC","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: Laser interstitial thermal therapy (LITT) has emerged as an alternative for treating glioblastoma (GBM) in patients deemed unsuitable for resection due to deep-seated or eloquent location, age, or comorbidities. However, its safety and efficacy in large-volume, deep-seated, newly diagnosed GBM (nGBM) tumors remain insufficiently studied. Therefore, the authors aimed to assess the outcomes of LITT in the treatment of deep-seated, large-volume nGBM.
Methods: A retrospective analysis of patients with nGBM who underwent LITT between February 2013 and August 2023 was conducted. Patients with deep-seated tumor volume ≥ 10 cm3 treated with LITT were compared to patients with deep-seated tumor volume < 10 cm3. Demographic, perioperative, and follow-up data were collected and compared among both groups. Kaplan-Meier survival analysis and Cox proportional hazards regression were performed to evaluate the impact of various clinical and treatment-related factors on patient survival.
Results: A total of 33 patients in the study group (mean ± SD age 65.7 ± 10.2 years, 58% male) with mean tumor volume 36.0 ± 21.6 cm3 were compared to 23 controls (mean age 67.0 ± 12.5 years, 61% male) with mean tumor volume 5.2 ± 2.7 cm3. There were no significant differences in hospital length of stay (p = 0.494), temporary neurological deficits and edema within 30 days (p = 0.705 and p > 0.999, respectively), 30-day readmissions (p = 0.139), < 30-day complications (p = 0.918), complications between 30 days and 3 months (p = 0.903), and new motor and speech deficits within 3 months (p = 0.883 and p > 0.999, respectively) between the study and control groups. Kaplan-Meier analysis did not reveal any statistically significant difference in overall survival (OS) between groups (p = 0.227). Multivariate analysis indicated that tumor volume did not significantly affect the hazard ratio for individuals undergoing LITT (HR 1.16, 95% CI 0.83-3.29, p = 0.150).
Conclusions: This pilot study suggests that LITT is safe for treating patients with large-volume, deep-seated nGBM compared to those with small-volume tumor. Although there appears to be improved OS in patients with smaller lesions with greater EOA, significance was not achieved in this cohort.
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