Hussain Sohail Rangwala, Muhammad Ashir Shafique, Muhammad Saqlain Mustafa, Ritesh Kumar, Janta Devi, Burhanuddin Sohail Rangwala, Syed Muhammad Sinaan Ali, Adarsh Raja, Javed Iqbal, Mirha Ali, Abdul Haseeb
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Eligible studies focused on LITT for supratentorial GB in adults and evaluated its safety and efficacy. Data extraction covered various study characteristics, and statistical analysis was performed using the OpenMeta Analyst software. Quality assessment was performed using the Newcastle-Ottawa Scale. Fifteen studies were analyzed, mainly employing the Neuroblate-Monteris system in the US, as retrospective single-centre trials. Treatment involved LITT in 239 patients with tumours typically in deep-seated areas. Median OS ranged from 4.9 to 32.3 months, and PFS from two to 5.9 months. Most patients received adjuvant therapy, primarily radiation and temozolomide. While LITT showed efficacy in improving OS (10.21, 95% CI 9.05-11.37), PFS (3.94, 95% CI 3.20-4.69), and tumor volume reduction (18.23, 95% CI 14.591-21.860), complications odd-ration(OR) = 0.336 (95% CI, 0.188-0.484) and mortality rates OR = 0.033 (95% CI, 0.009-0.058 were notable. LITT shows promise for treating both newly diagnosed and recurrent GB cases in non-surgical candidates, linked to improved OS, PFS, reduced tumor volume, and shorter hospital stays. 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引用次数: 0
摘要
胶质母细胞瘤(GB)是最常见的恶性脑肿瘤,尽管治疗手段不断进步,但预后较差。标准治疗包括手术和放化疗。磁共振成像引导下的激光间质热疗(LITT)是一种微创技术,可为具有特定临床特征的特定患者提供一种选择。虽然临床前研究表明 LITT 可以破坏血脑屏障 (BBB),从而加强药物输送,但这一点尚未在临床环境中得到明确证实。根据PRISMA指南,我们对各种数据库进行了检索,直至2024年3月。符合条件的研究主要针对成人脑室上部 GB 的 LITT,并对其安全性和有效性进行了评估。数据提取涵盖了各种研究特征,并使用 OpenMeta Analyst 软件进行了统计分析。采用纽卡斯尔-渥太华量表进行质量评估。共对 15 项研究进行了分析,这些研究主要采用了美国的 Neuroblate-Monteris 系统,属于回顾性单中心试验。239名肿瘤通常位于深部的患者接受了LITT治疗。中位 OS 为 4.9 到 32.3 个月,PFS 为 2 到 5.9 个月。大多数患者接受了辅助治疗,主要是放疗和替莫唑胺。LITT在改善OS(10.21,95% CI 9.05-11.37)、PFS(3.94,95% CI 3.20-4.69)和肿瘤体积缩小(18.23,95% CI 14.591-21.860)方面显示出疗效,但并发症奇异率(OR)= 0.336(95% CI,0.188-0.484)和死亡率OR= 0.033(95% CI,0.009-0.058)值得注意。LITT有望治疗非手术治疗的新诊断和复发GB病例,可改善OS、PFS、减少肿瘤体积和缩短住院时间。然而,并发症和死亡率较高,因此需要进行更多设计良好的前瞻性多中心试验。
Evaluating efficacy and safety of laser interstitial thermal therapy in patients with newly diagnosed and recurrent glioblastoma: a systematic review and meta-analysis.
Glioblastoma (GB), the most common malignant brain tumour, has a poor prognosis despite advances in treatment. Standard management involves surgery followed by chemoradiotherapy. MRI-guided laser interstitial thermal therapy (LITT) is a minimally invasive technique that may offer an option for select patients with specific clinical profiles. While preclinical studies suggest that LITT could disrupt the blood-brain barrier (BBB) to enhance drug delivery, this has yet to be definitively demonstrated in clinical settings. Adhering to the PRISMA guidelines, various databases were searched until March 2024. Eligible studies focused on LITT for supratentorial GB in adults and evaluated its safety and efficacy. Data extraction covered various study characteristics, and statistical analysis was performed using the OpenMeta Analyst software. Quality assessment was performed using the Newcastle-Ottawa Scale. Fifteen studies were analyzed, mainly employing the Neuroblate-Monteris system in the US, as retrospective single-centre trials. Treatment involved LITT in 239 patients with tumours typically in deep-seated areas. Median OS ranged from 4.9 to 32.3 months, and PFS from two to 5.9 months. Most patients received adjuvant therapy, primarily radiation and temozolomide. While LITT showed efficacy in improving OS (10.21, 95% CI 9.05-11.37), PFS (3.94, 95% CI 3.20-4.69), and tumor volume reduction (18.23, 95% CI 14.591-21.860), complications odd-ration(OR) = 0.336 (95% CI, 0.188-0.484) and mortality rates OR = 0.033 (95% CI, 0.009-0.058 were notable. LITT shows promise for treating both newly diagnosed and recurrent GB cases in non-surgical candidates, linked to improved OS, PFS, reduced tumor volume, and shorter hospital stays. However, higher complication and mortality rates were noted, emphasising the need for additional well-designed prospective multicentre trials.
期刊介绍:
The goal of Neurosurgical Review is to provide a forum for comprehensive reviews on current issues in neurosurgery. Each issue contains up to three reviews, reflecting all important aspects of one topic (a disease or a surgical approach). Comments by a panel of experts within the same issue complete the topic. By providing comprehensive coverage of one topic per issue, Neurosurgical Review combines the topicality of professional journals with the indepth treatment of a monograph. Original papers of high quality are also welcome.