BACKGROUND: The extent of resection (EOR) of high-grade gliomas (WHO grade III or IV) in or near areas of eloquence is associated with overall patient survival, but with higher major neurocognitive complications. METHODS: A systematic review and meta-analysis was undertaken of the peer-reviewed literature in order to identify studies which examined EOR or extent of ablation (EOA) and major complications (defined as neurocognitive or functional complications which last >3 months duration after surgery) associated with either brain laser interstitial thermal therapy (LITT) or open craniotomy in high-grade tumors in or near areas of eloquence. RESULTS: Eight studies on brain LITT (n = 79 patients) and 12 craniotomy studies (n = 1,036 patients) were identified which examined either/both EOR/EOA and complications. Meta-analysis demonstrated an EOA/EOR of 85.4 ± 10.6% with brain LITT versus 77.0 ± 40% with craniotomy (mean difference: 8%; 95% CI: 2-15; p = 0.01; inverse variance, random effects model). Meta-analysis of proportions of major complications for each individual therapy demonstrated major complications of 5.7% (95% CI: 1.8-11.6) and 13.8% (95% CI: 10.3-17.9) for LITT and craniotomy, respectively. CONCLUSION: In patients presenting with high-grade gliomas in or near areas of eloquence, early results demonstrate that brain LITT may be a viable surgical alternative.
BACKGROUND: The extent of resection (EOR) of high-grade gliomas (WHO grade III or IV) in or near areas of eloquence is associated with overall patient survival, but with higher major neurocognitive complications. METHODS: A systematic review and meta-analysis was undertaken of the peer-reviewed literature in order to identify studies which examined EOR or extent of ablation (EOA) and major complications (defined as neurocognitive or functional complications which last >3 months duration after surgery) associated with either brain laser interstitial thermal therapy (LITT) or open craniotomy in high-grade tumors in or near areas of eloquence. RESULTS: Eight studies on brain LITT (n = 79 patients) and 12 craniotomy studies (n = 1,036 patients) were identified which examined either/both EOR/EOA and complications. Meta-analysis demonstrated an EOA/EOR of 85.4 ± 10.6% with brain LITT versus 77.0 ± 40% with craniotomy (mean difference: 8%; 95% CI: 2-15; p = 0.01; inverse variance, random effects model). Meta-analysis of proportions of major complications for each individual therapy demonstrated major complications of 5.7% (95% CI: 1.8-11.6) and 13.8% (95% CI: 10.3-17.9) for LITT and craniotomy, respectively. CONCLUSION: In patients presenting with high-grade gliomas in or near areas of eloquence, early results demonstrate that brain LITT may be a viable surgical alternative.
Authors: A L Bredlau; M A McCrackin; Anjan Motamarry; Kris Helke; Chao Chen; Ann-Marie Broome; Dieter Haemmerich Journal: Crit Rev Biomed Eng Date: 2016
Authors: H Petra Kok; Erik N K Cressman; Wim Ceelen; Christopher L Brace; Robert Ivkov; Holger Grüll; Gail Ter Haar; Peter Wust; Johannes Crezee Journal: Int J Hyperthermia Date: 2020 Impact factor: 3.914
Authors: Georgios P Skandalakis; Daniel R Rivera; Caroline D Rizea; Alexandros Bouras; Joe Gerald Jesu Raj; Dominique Bozec; Constantinos G Hadjipanayis Journal: Int J Hyperthermia Date: 2020-07 Impact factor: 3.914