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
Abstract
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.
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.
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