Robert C Rennert1, Usman Khan1, Stephen B Tatter2, Melvin Field3, Brian Toyota4, Peter E Fecci5, Kevin Judy6, Alireza M Mohammadi7, Patrick Landazuri8, Andrew Sloan9, Eric Leuthardt10, Clark C Chen11. 1. Department of Neurosurgery, University of California San Diego, San Diego, California, USA. 2. Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA. 3. Orlando Neurosurgery, Orlando, Florida, USA. 4. Division of Neurosurgery, Vancouver General Hospital, Vancouver, British Columbia, Canada. 5. Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA. 6. Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA. 7. Department of Neurosurgery, Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, Ohio, USA. 8. Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas, USA. 9. Department of Neurological Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA. 10. Department of Neurosurgery, Washington University, St. Louis, Missouri, USA. 11. Department of Neurosurgery, University of Minnesota, Minneapolis, Minnesota, USA. Electronic address: ccchen@umn.edu.
Abstract
BACKGROUND: Stereotactic laser ablation (SLA), also termed laser interstitial thermal therapy, is a minimally invasive procedure that is increasingly used in neurosurgery. We wished to examine how and whether SLA is changing the landscape of treatment options for neurosurgical patients. METHODS: Patients undergoing stereotactic laser ablation were prospectively enrolled in the Laser Ablation of Abnormal Neurological Tissue (LAANTERN) registry. Data from the first 100 enrolled patients are presented here. RESULTS: Clinical indications for SLA include treatment of primary intracranial tumors (48%; 81% being high-grade gliomas [HGGs]), brain metastases (BMs, 34%), epilepsy (16%), and other (2%). For HGGs, SLA was equally likely used for newly diagnosed (45%) or previously treated/recurrent lesions (55%, P = 0.54). By contrast, SLA was predominantly used as treatment for BMs in which radiation therapy/radiosurgery had failed (91%), with only 9% of SLAs performed as initial treatment for newly diagnosed lesions (P < 0.001). Of all SLAs performed, 45% of the procedures were in lieu of surgical resection, with 43% performed because the lesion was not accessible by conventional neurosurgical techniques. CONCLUSION: HGGs and BMs are the leading indications for SLA in the LAANTERN study. For HGGs, SLA is equally used in the presenting or previously treated/recurrent setting. For BMs, SLA is typically used in the recurrent setting. SLAs are equally likely to be performed for difficult-to-access lesions or in lieu of conventional open surgery.
BACKGROUND: Stereotactic laser ablation (SLA), also termed laser interstitial thermal therapy, is a minimally invasive procedure that is increasingly used in neurosurgery. We wished to examine how and whether SLA is changing the landscape of treatment options for neurosurgical patients. METHODS:Patients undergoing stereotactic laser ablation were prospectively enrolled in the Laser Ablation of Abnormal Neurological Tissue (LAANTERN) registry. Data from the first 100 enrolled patients are presented here. RESULTS: Clinical indications for SLA include treatment of primary intracranial tumors (48%; 81% being high-grade gliomas [HGGs]), brain metastases (BMs, 34%), epilepsy (16%), and other (2%). For HGGs, SLA was equally likely used for newly diagnosed (45%) or previously treated/recurrent lesions (55%, P = 0.54). By contrast, SLA was predominantly used as treatment for BMs in which radiation therapy/radiosurgery had failed (91%), with only 9% of SLAs performed as initial treatment for newly diagnosed lesions (P < 0.001). Of all SLAs performed, 45% of the procedures were in lieu of surgical resection, with 43% performed because the lesion was not accessible by conventional neurosurgical techniques. CONCLUSION: HGGs and BMs are the leading indications for SLA in the LAANTERN study. For HGGs, SLA is equally used in the presenting or previously treated/recurrent setting. For BMs, SLA is typically used in the recurrent setting. SLAs are equally likely to be performed for difficult-to-access lesions or in lieu of conventional open surgery.
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