Laser interstitial thermal therapy in treatment of brain tumors – the NeuroBlate System

Abstract

Treatment of brain tumors remains challenging. Cytoreductive surgery is used as the first line treatment for most brain tumors. However complete, curative, resection is not achievable in many tumors leading to the need for adjuvant chemotherapy and radiation therapy. Laser interstitial thermal therapy (LITT) is a minimally invasive cytoreductive treatment. A low voltage laser is used to induce hyperthermia and to kill tumor cells. The extent of thermal damage is controlled through use of real-time MR-thermography guidance. Initial results have shown the feasibility of LITT for a variety of brain pathologies. LITT can be considered as an alternative type of surgery for difficult to access brain tumors and also for tumors in patients who are deemed high risk for more traditional surgery. Randomized trials are currently planned to continue assessing the efficacy of LITT and long-term follow-up data are awaited.

Keywords::

• brain metastases
• glioma
• laser in medicine
• laser interstitial thermal therapy
• minimally invasive surgery
• NeuroBlate System
• radiation necrosis
• tumor hyperthermic treatment

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Treatment of malignant brain tumors is still challenging, especially for difficult-to-access tumors in which aggressive surgical resection can cause significant complications.

• Laser interstitial thermal therapy provides a less invasive alternative to traditional open surgery in patients with difficult-to-access brain lesions.

• Near-total coverage of the tumor volume by thermal-damage-threshold lines has been shown to have an impact on progression-free survival for malignant glioma patients.

• The NeuroBlate System has FDA clearance for use in intracranial pathologies.

• Long-term outcomes and further data regarding laser interstitial thermal therapy treatment for various types of brain conditions are keenly awaited.