激光间质热治疗（LITT）和免疫治疗对脑肿瘤复发的协同作用：系统回顾和荟萃分析。

IF 1.5 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie Pub Date : 2025-01-03 DOI:10.1016/j.neuchi.2025.101629

Eshita Sharma , Oguz Kagan Sahin , Paweł Łajczak , Numa Rajab , Aisha Rizwan Ahmed , Yasmin Picanço Silva , Ayesha Bakhsh , Anoushka Chatterjee , Mohammed Raake , Walter Fagundes

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引用次数: 0

摘要

目的：激光间质热治疗（LITT）与免疫治疗方法的融合是治疗复发性脑病变的一个有希望的选择。然而，这些模式之间的潜在协同作用仍不清楚。本荟萃分析检查了文献，以阐明与此联合治疗复发性脑转移瘤和胶质母细胞瘤相关的不良反应和总生存率。方法：系统检索PubMed、Embase和Web of Science数据库。纳入标准包括在诊断为复发性脑转移和复发性胶质母细胞瘤的成年患者中调查LITT与免疫治疗联合使用的研究。我们的分析采用随机效应模型，汇总了所有纳入研究的总生存期（OS）和不良事件（ae）。结果：我们分析了来自1项随机对照试验和3项非随机研究的162例患者。所有患者的合并分析显示中位OS为12.8个月(95% CI = 8.31-17.31；结论：该荟萃分析显示，与传统治疗方式相比，安全性和总生存期具有潜在的可比性。需要进一步的研究来测试免疫治疗与对照组相比，LITT的ae和OS发生率的差异。

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Synergistic effects of laser interstitial thermal therapy (LITT) and immunotherapy for brain tumor recurrence: A systematic review and meta-analysis

Purpose

The confluence of laser interstitial thermal therapy (LITT) with immunotherapeutic approaches represents a promising option for managing recurrent brain lesions. However, the potential synergy between these modalities is still unclear. This meta-analysis examines the literature to elucidate the adverse effects and overall survival associated with this combination in treating recurrent brain metastases and glioblastoma.

Methods

Systematic searches were performed on PubMed, Embase, and Web of Science databases. Inclusion criteria comprised studies investigating the combined utilization of LITT with immunotherapy, among adult patients diagnosed with recurrent brain metastases and recurrent glioblastoma. Our analysis, using a random-effects model, pooled Overall Survival (OS) and Adverse events (AEs) from all the included studies.

Results

We analyzed 162 patients from one RCT and three non-randomized studies. The pooled analysis of all patients revealed a median OS of 12.8 months (95% CI = 8.31–17.31; p < 0.01) with the combined treatment of LITT and immunotherapy. Similarly, approximately 6% of patients experienced AEs (95% CI = −0.01–0.11; p = 0.03). Subgroup analysis further demonstrated that among patients with recurrent glioma, the combined treatment showed pooled OS of 11 months (95% CI = 7.13–16.62; p < 0.01), while AEs were observed in 4% of patients (95% CI = −0.02–0.10; p = 0.21).

Conclusion

This meta-analysis showed a potentially comparable safety profile and overall survival to conventional treatment modalities. Further research is warranted to test differences in the incidence of AEs and OS from LITT with immunotherapy versus a control.

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来源期刊

Neurochirurgie 医学-临床神经学

CiteScore

2.70

自引率

6.20%

发文量

100

审稿时长

29 days

期刊介绍： Neurochirurgie publishes articles on treatment, teaching and research, neurosurgery training and the professional aspects of our discipline, and also the history and progress of neurosurgery. It focuses on pathologies of the head, spine and central and peripheral nervous systems and their vascularization. All aspects of the specialty are dealt with: trauma, tumor, degenerative disease, infection, vascular pathology, and radiosurgery, and pediatrics. Transversal studies are also welcome: neuroanatomy, neurophysiology, neurology, neuropediatrics, psychiatry, neuropsychology, physical medicine and neurologic rehabilitation, neuro-anesthesia, neurologic intensive care, neuroradiology, functional exploration, neuropathology, neuro-ophthalmology, otoneurology, maxillofacial surgery, neuro-endocrinology and spine surgery. Technical and methodological aspects are also taken onboard: diagnostic and therapeutic techniques, methods for assessing results, epidemiology, surgical, interventional and radiological techniques, simulations and pathophysiological hypotheses, and educational tools. The editorial board may refuse submissions that fail to meet the journal''s aims and scope; such studies will not be peer-reviewed, and the editor in chief will promptly inform the corresponding author, so as not to delay submission to a more suitable journal. With a view to attracting an international audience of both readers and writers, Neurochirurgie especially welcomes articles in English, and gives priority to original studies. Other kinds of article - reviews, case reports, technical notes and meta-analyses - are equally published. Every year, a special edition is dedicated to the topic selected by the French Society of Neurosurgery for its annual report.