Skip to main content

Efficacy of laser interstitial thermal therapy for biopsy-proven radiation necrosis in radiographically recurrent brain metastases.

Publication ,  Journal Article
Chan, M; Tatter, S; Chiang, V; Fecci, P; Strowd, R; Prabhu, S; Hadjipanayis, C; Kirkpatrick, J; Sun, D; Sinicrope, K; Mohammadi, AM; Sevak, P ...
Published in: Neurooncol Adv
2023

BACKGROUND: Laser interstitial thermal therapy (LITT) in the setting of post-SRS radiation necrosis (RN) for patients with brain metastases has growing evidence for efficacy. However, questions remain regarding hospitalization, local control, symptom control, and concurrent use of therapies. METHODS: Demographics, intraprocedural data, safety, Karnofsky performance status (KPS), and survival data were prospectively collected and then analyzed on patients who consented between 2016-2020 and who were undergoing LITT for biopsy-proven RN at one of 14 US centers. Data were monitored for accuracy. Statistical analysis included individual variable summaries, multivariable Fine and Gray analysis, and Kaplan-Meier estimated survival. RESULTS: Ninety patients met the inclusion criteria. Four patients underwent 2 ablations on the same day. Median hospitalization time was 32.5 hours. The median time to corticosteroid cessation after LITT was 13.0 days (0.0, 1229.0) and cumulative incidence of lesional progression was 19% at 1 year. Median post-procedure overall survival was 2.55 years [1.66, infinity] and 77.1% at one year as estimated by KaplanMeier. Median KPS remained at 80 through 2-year follow-up. Seizure prevalence was 12% within 1-month post-LITT and 7.9% at 3 months; down from 34.4% within 60-day prior to procedure. CONCLUSIONS: LITT for RN was not only again found to be safe with low patient morbidity but was also a highly effective treatment for RN for both local control and symptom management (including seizures). In addition to averting expected neurological death, LITT facilitates ongoing systemic therapy (in particular immunotherapy) by enabling the rapid cessation of steroids, thereby facilitating maximal possible survival for these patients.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Neurooncol Adv

DOI

EISSN

2632-2498

Publication Date

2023

Volume

5

Issue

1

Start / End Page

vdad031

Location

England
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Chan, M., Tatter, S., Chiang, V., Fecci, P., Strowd, R., Prabhu, S., … Laxton, A. (2023). Efficacy of laser interstitial thermal therapy for biopsy-proven radiation necrosis in radiographically recurrent brain metastases. Neurooncol Adv, 5(1), vdad031. https://doi.org/10.1093/noajnl/vdad031
Chan, Michael, Steven Tatter, Veronica Chiang, Peter Fecci, Roy Strowd, Sujit Prabhu, Constantinos Hadjipanayis, et al. “Efficacy of laser interstitial thermal therapy for biopsy-proven radiation necrosis in radiographically recurrent brain metastases.Neurooncol Adv 5, no. 1 (2023): vdad031. https://doi.org/10.1093/noajnl/vdad031.
Chan M, Tatter S, Chiang V, Fecci P, Strowd R, Prabhu S, et al. Efficacy of laser interstitial thermal therapy for biopsy-proven radiation necrosis in radiographically recurrent brain metastases. Neurooncol Adv. 2023;5(1):vdad031.
Chan, Michael, et al. “Efficacy of laser interstitial thermal therapy for biopsy-proven radiation necrosis in radiographically recurrent brain metastases.Neurooncol Adv, vol. 5, no. 1, 2023, p. vdad031. Pubmed, doi:10.1093/noajnl/vdad031.
Chan M, Tatter S, Chiang V, Fecci P, Strowd R, Prabhu S, Hadjipanayis C, Kirkpatrick J, Sun D, Sinicrope K, Mohammadi AM, Sevak P, Abram S, Kim AH, Leuthardt E, Chao S, Phillips J, Lacroix M, Williams B, Placantonakis D, Silverman J, Baumgartner J, Piccioni D, Laxton A. Efficacy of laser interstitial thermal therapy for biopsy-proven radiation necrosis in radiographically recurrent brain metastases. Neurooncol Adv. 2023;5(1):vdad031.

Published In

Neurooncol Adv

DOI

EISSN

2632-2498

Publication Date

2023

Volume

5

Issue

1

Start / End Page

vdad031

Location

England