Early research indicates that a less invasive laser procedure has promising benefits for those diagnosed with glioblastoma, one of the most malignant and complex types of brain tumor. A recent study indicates that appropriately timed laser interstitial thermal therapy, or LITT, can provide additional years of life to patients with otherwise inaccessible or Untreatable brain cancers.
The newest reports are from a large prospective cohort of 787 patients with brain tumors who were treated with MRI-guided laser interstitial thermal therapy. The authors found that survival outcomes were strongly related to how much of the tumor was ablated with the laser and, in a subset of cases, timing of the procedure.
The work gives yet more data to support this focused approach as a potentially important option for patients not able to receive traditional open-brain surgery. Glioblastoma is still one of the deadliest primar brain cancers in adults. The standard treatment for a glioma is usually surgery to remove as much of the tumor as possible, followed by radiation and chemo therapy.
Although in some cases the tumor is too deep inside the brain or is situated too near to the movement and speech areas to allow a standard surgical operation. LITT has another method. Instead of terminating a large piece of the skull, a thin laser probe was inserted through a tiny hole and directed toward the cancer site by state of the art imaging.
There the laser energies heats the cancer cells and kills them, while an MRI beam gives feedback to the doctors doing the operation. The minimally-invasive characteristic of the treatment may be mostly useful for tumors that are inoperable through normal surgery. There has been an increasing research on whether the technique can do more than simply provide the alternative to surgery.
The most recent WashU study found, that ablation dose is one of the most crucial factors. In a population of newly diagnosed glioblastoma patients, prolongation of survival was achieved if at least 91% of the tumor was ablated. Smaller volume tumors were also related to prolongation of survival.
Another promising signal emerged from a published separate RCT in The Lancet Regional Health Europe. This trial compared biopsied-only patients against also encountered patients receiving a biopsy and same-session MRI-guided LITT before anything else. Median survival was 7.
8 months for patients who received LITT compared to 4.8months for patients who just had a biopsy. Still the investigators highlighted that there was only 26 patients in the final analysis in the trial with baseline differences between the groups meaning the study cannot be used to definitively prove that LITT prolongs survival.
Larger studies are still required. In reality the results still provide encouragement for patients with unresectable tumors. The extension of survival by a few months in glioblastoma is a meaningful clinical benefit, given the poor prognosis of this disease and the limited available treatment after recurrence.