Laser Interstitial Thermal Therapy for Radionecrosis

Alexis Paul Romain Terrapon; Marie Krüger; Thomas Hundsberger; Marian Christoph Neidert; Oliver Bozinov

doi:10.1016/j.nec.2022.11.001

Laser Interstitial Thermal Therapy for Radionecrosis

Neurosurg Clin N Am. 2023 Apr;34(2):209-225. doi: 10.1016/j.nec.2022.11.001. Epub 2023 Jan 31.

Authors

Alexis Paul Romain Terrapon¹, Marie Krüger², Thomas Hundsberger³, Marian Christoph Neidert¹, Oliver Bozinov⁴

Affiliations

¹ Department of Neurosurgery, Kantonsspital St. Gallen, Medical School St. Gallen, Rorschacher Strasse 95, St. Gallen 9007, Switzerland.
² Department of Neurosurgery, Kantonsspital St. Gallen, Medical School St. Gallen, Rorschacher Strasse 95, St. Gallen 9007, Switzerland; Unit of Functional Neurosurgery, Institute of Neurology and Neurosurgery, 33 Queen Square, London WC1N 3BG, UK; Department of Stereotactic and Functional Neurosurgery, University Medical Center Freiburg, Breisacher Strasse 64, Freiburg 79095, Germany.
³ Department of Neurology and of Oncology, Kantonsspital St. Gallen, Medical School St. Gallen, Rorschacher Strasse 95, St. Gallen 9007, Switzerland.
⁴ Department of Neurosurgery, Kantonsspital St. Gallen, Medical School St. Gallen, Rorschacher Strasse 95, St. Gallen 9007, Switzerland. Electronic address: [email protected].

PMID: 36906328
DOI: 10.1016/j.nec.2022.11.001

Abstract

Radiotherapy is widely used for brain tumors but can cause radiation necrosis (RN). Laser interstitial thermal therapy (LITT) is a relatively new therapeutic modality for RN and its impact on patient outcome is still not well understood. Based on a systematic literature search (n=33), the authors discuss the available evidence. Most studies found a positive safety/efficacy profile, as LITT may help to lengthen survival, prevent progression, taper steroids, and improve neurological symptoms while remaining safe. Prospective studies on this subject are needed and may result in LITT becoming an essential therapeutic option for the treatment of RN.

Keywords: Ablation; LITT; Outcome; Radiation necrosis; Radiotherapy; Recurrence; Review; Safety.

Publication types

Review

MeSH terms

Brain Neoplasms* / surgery
Humans
Hyperthermia, Induced*
Laser Therapy*
Lasers
Prospective Studies