Laser Interstitial Thermal Therapy for Recurrent Glioblastoma: Pooled Analyses of Available Literature.

Abstract

INTRODUCTION\nWe conduct a systematic review and pooled analysis of the literature for outcomes on patients with recurrent glioblastoma (rGBM) undergoing laser interstitial thermal therapy (LITT).\n\n\nMETHODS\nA literature search was performed to retrieve all studies investigating overall survival, post-procedure survival and progression-free survival outcomes of patients with rGBM undergoing LITT. Statistics were pooled together by meta-analysis of mean using a weighted random-effects (RE) or fixed-effect (FE) model.\n\n\nRESULTS\nEleven studies were included in the final cohort, representing a total of 134 patients with rGBM. The pooled mean age of the cohort at the time of recurrence diagnosis was found to be 56.7 ± 4.56 while 41% of the cohort were females. For delivery of LITT, two studies utilized neodymium-yttriumaluminum-garnet laser (Neodp-YAG Laser), three studies utilized the Visualase system, five studies utilized the Neuroblate system, and one study used both the Neuroblate and the Visualase system. A total of eight studies with 107 patients had available data for overall median survival. The pooled overall survival was found to be 18.6 months (95%CI 16.2-21.1). A total of six studies with 93 patients had available data for post-LITT survival. The pooled post-LITT survival was found to be 10.1 months (95%CI 8.8-11.6). A total of eight studies with 119 patients had available data for progression free survival. Pooled progression free survival was found to be 6 months (95%CI 5.3-6.7).\n\n\nCONCLUSION\nLITT is a novel minimally invasive procedure which, when used with optimal adjuvant therapy, may confer survival benefit for patients with rGBM.