Prognostic factors of overall survival after laser interstitial thermal therapy in patients with glioblastoma

Abstract Background: Laser interstitial thermal therapy (LITT) is a minimally invasive technique for treating intracranial tumors percutaneously. Controlled thermal damage to the tumor may offer an adjunct to the treatment of glioblastoma multiforme (GBM) especially in deep-seated locations. We report our series of patients with GBM treated with LITT. Methods: Eleven consecutive patients with GBM who underwent LITT at the Cleveland Clinic using the NeuroBlate® System were retrospectively reviewed. The extent of tumor treatment was determined using thermal-damage-threshold (TDT) lines: yellow TDT-line (reached by heating tissue to at least 43°C for 2 min) and blue TDT-line (43°C for 10 min). Volumetric analysis was performed to determine the extent of coverage of tumor volume by the TDT-lines. Kaplan-Meier curves and Cox regression analysis were used to evaluate patient outcomes. Results: LITT was delivered as upfront treatment in six cases and delivered as salvage in five cases. After 26.2 months of follow-up, 73% of cases demonstrated progression and 54.5% died. The median overall survival (OS) for the cohort was 8.4 months. Median progression free survival (PFS) was 6.1 months. A tendency towards improved overall survival was discovered in patients who had near complete coverage of tumor by blue and yellow TDT-lines. Conclusions: LITT can be used in a safe and effective manner for the treatment of patients with difficult to access GBM. Improved coverage of the tumor by the TDT-treatment lines has a tendency to improve patient overall survival.