Journal article
Combination laser interstitial thermal therapy plus stereotactic radiotherapy increases time to progression for biopsy-proven recurrent brain metastases
Neuro-oncology advances, v 4(1), 086
01 Jan 2022
PMID: 35795470
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background Improved survival for patients with brain metastases has been accompanied by a rise in tumor recurrence after stereotactic radiotherapy (SRT). Laser interstitial thermal therapy (LITT) has emerged as an effective treatment for SRT failures as an alternative to open resection or repeat SRT. We aimed to evaluate the efficacy of LITT followed by SRT (LITT+SRT) in recurrent brain metastases.
Methods A multicenter, retrospective study was performed of patients who underwent treatment for biopsy-proven brain metastasis recurrence after SRT at an academic medical center. Patients were stratified by "planned LITT+SRT" versus "LITT alone" versus "repeat SRT alone." Index lesion progression was determined by modified Response Assessment in Neuro-Oncology Brain Metastases (RANO-BM) criteria.
Results Fifty-five patients met inclusion criteria, with a median follow-up of 7.3 months (range: 1.0-30.5), age of 60 years (range: 37-86), Karnofsky Performance Status (KPS) of 80 (range: 60-100), and pre-LITT/biopsy contrast-enhancing volume of 5.7 cc (range: 0.7-19.4). Thirty-eight percent of patients underwent LITT+SRT, 45% LITT alone, and 16% SRT alone. Median time to index lesion progression (29.8, 7.5, and 3.7 months [P = .022]) was significantly improved with LITT+SRT. When controlling for age in a multivariate analysis, patients treated with LITT+SRT remained significantly less likely to have index lesion progression (P = .004).
Conclusions These data suggest that LITT+SRT is superior to LITT or repeat SRT alone for treatment of biopsy-proven brain metastasis recurrence after SRT failure. Prospective trials are warranted to validate the efficacy of using combination LITT+SRT for treatment of recurrent brain metastases.
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Details
- Title
- Combination laser interstitial thermal therapy plus stereotactic radiotherapy increases time to progression for biopsy-proven recurrent brain metastases
- Creators
- Matthew M. Grabowski - Cleveland ClinicEthan S. Srinivasan - Duke University HospitalEugene J. Vaios - Duke Medical CenterEric W. Sankey - Duke University HospitalBalint Otvos - Case Comprehensive Cancer CenterDaria Krivosheya - Case Comprehensive Cancer CenterAlex Scott - Washington University in St. LouisMichael Olufawo - Washington University in St. LouisJun Ma - University of MinnesotaElena Fomchenko - Yale UniversityJames E. Herndon - Duke UniversityAlbert H. Kim - Washington University in St. LouisVeronica L. Chiang - Yale UniversityClark C. Chen - University of MinnesotaEric C. Leuthardt - Washington University in St. LouisGene H. Barnett - Cleveland ClinicJohn P. Kirkpatrick - Duke Medical CenterAlireza M. Mohammadi - Cleveland ClinicPeter E. Fecci - Duke University Hospital
- Publication Details
- Neuro-oncology advances, v 4(1), 086
- Publisher
- Oxford Univ Press
- Number of pages
- 9
- Grant note
- R38CA245204 / National Cancer Institute; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurology
- Web of Science ID
- WOS:000852789900094
- Scopus ID
- 2-s2.0-85134998154
- Other Identifier
- 991022004872904721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Clinical Neurology
- Oncology