Stereotactic laser induced thermotherapy (LITT): a novel treatment for brain lesions regrowing after radiosurgery.

摘要: Since the inception of radiosurgery, management brain metastases has become a common problem for neurosurgeons. Although use stereotactic radiosurgery and/or whole radiation therapy serves to control majority disease burden, patients who survive longer than 6–8 months sometimes face symptomatic radiographically regrowing lesions with few treatment options. Here we investigate feasibility MRI-guided laser induced thermotherapy (LITT) as novel option these lesions. Six had previously undergone gamma knife were selected. All an initial favorable response but subsequently developed regrowth at least one lesion associated recurrent edema and progressive neurological symptoms requiring ongoing steroids symptom control. evaluated craniotomy, deemed unresectable due deep location or patient’s comorbidities. Stereotactic biopsies performed prior procedure in all cases. LITT was using Visualase system follow-up MRI imaging used determine response. In six biopsy results negative tumor consistent adverse effects also known necrosis. Patients tolerated well discharged from hospital within 48 h procedure. 4/6 cases there durable improvement until death. weaned off 2 months. One patient died systemic causes related his cancer month after 3 months required re-initiation standard craniotomy surgical resection. There no complications directly thermocoagulation is feasible alternative metastatic radiosurgery. The carries minimal morbidity and, this small series, shows some effectiveness relief paralleled by radiographic lesional Further studies are necessary elucidate safety technology.