scholarly journals The role of laser interstitial thermal therapy in enhancing progression‐free survival of difficult‐to‐access high‐grade gliomas: a multicenter study

2014 ◽  
Vol 3 (4) ◽  
pp. 971-979 ◽  
Author(s):  
Alireza M. Mohammadi ◽  
Ammar H. Hawasli ◽  
Analiz Rodriguez ◽  
Jason L. Schroeder ◽  
Adrian W. Laxton ◽  
...  
Keyword(s):  
Multicenter Study ◽  
Progression Free Survival ◽  
Thermal Therapy ◽  
High Grade ◽  
Free Survival ◽  
Laser Interstitial Thermal Therapy ◽  
High Grade Gliomas

scholarly journals Stereotactic Laser Interstitial Thermal Therapy for Recurrent High-Grade Gliomas

Neurosurgery ◽  
2016 ◽  
Vol 79 (suppl_1) ◽  
pp. S24-S34 ◽  
Author(s):  
Ian Lee ◽  
Steven Kalkanis ◽  
Constantinos G. Hadjipanayis
Keyword(s):  
Thermal Therapy ◽  
Neurological Deficits ◽  
Current Evidence ◽  
High Grade ◽  
Medline Search ◽  
Laser Interstitial Thermal Therapy ◽  
Ablation Volume ◽  
Treatment Paradigm ◽  
High Grade Gliomas

Abstract BACKGROUND: The value of maximal safe cytoreductive surgery in recurrent high-grade gliomas (HGGs) is gaining wider acceptance. However, patients may harbor recurrent tumors that may be difficult to access with open surgery. Laser interstitial thermal therapy (LITT) is emerging as a technique for treating a variety of brain pathologies, including primary and metastatic tumors, radiation necrosis, and epilepsy. OBJECTIVE: To review the role of LITT in the treatment of recurrent HGGs, for which current treatments have limited efficacy, and to discuss the possible role of LITT in the disruption of the blood-brain barrier to increase delivery of chemotherapy locoregionally. METHODS: A MEDLINE search was performed to identify 17 articles potentially appropriate for review. Of these 17, 6 reported currently commercially available systems and as well as magnetic resonance thermometry to monitor the ablation and, thus, were thought to be most appropriate for this review. These studies were then reviewed for complications associated with LITT. Ablation volume, tumor coverage, and treatment times were also reviewed. RESULTS: Sixty-four lesions in 63 patients with recurrent HGGs were treated with LITT. Frontal (n = 34), temporal (n = 14), and parietal (n = 16) were the most common locations. Permanent neurological deficits were seen in 7 patients (12%), vascular injuries occurred in 2 patients (3%), and wound infection was observed in 1 patient (2%). Ablation coverage of the lesions ranged from 78% to 100%. CONCLUSION: Although experience using LITT for recurrent HGGs is growing, current evidence is insufficient to offer a recommendation about its role in the treatment paradigm for recurrent HGGs.

scholarly journals Progression-free survival: An important end point in evaluating therapy for recurrent high-grade gliomas

2008 ◽  
Vol 10 (2) ◽  
pp. 162-170 ◽  
Author(s):  
Kathleen R. Lamborn ◽  
W. K. Alfred Yung ◽  
Susan M. Chang ◽  
Patrick Y. Wen ◽  
Timothy F. Cloughesy ◽  
...  
Keyword(s):  
Progression Free Survival ◽  
High Grade ◽  
Free Survival ◽  
End Point ◽  
High Grade Gliomas

scholarly journals SURG-29. LASER INTERSTITIAL THERMAL THERAPY COMPARED TO CRANIOTOMY FOR TREATMENT OF RECURRENT GLIOBLASTOMA

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi245-vi245
Author(s):  
Ali Palejwala ◽  
Kyle O’connor ◽  
Chad Glenn ◽  
Michael Sughrue
Keyword(s):  
Overall Survival ◽  
Adjuvant Therapy ◽  
Perioperative Complications ◽  
Progression Free Survival ◽  
Senior Author ◽  
Thermal Therapy ◽  
Free Survival ◽  
Laser Interstitial Thermal Therapy ◽  
Significant Difference ◽  
Recurrent Gbm

Abstract There have been publications that propose the use of laser interstitial thermal therapy (LITT) as a viable alternative to craniotomy for the treatment of glioblastoma (GBM). The aim of this study was to retrospectively compare outcomes after LITT versus craniotomy for patients with recurrent GBM. To adequately match the cohorts, we included only pre-treatment tumor volumes of under 15 cc. We retrospectively collected data on all patients presenting with recurrent GBM, with a recurrence volume under 15 cc. These patients were either treated with LITT or craniotomy by the senior author. Data included demographics, tumor location and volume, tumor markers, perioperative complications, re-initiation of adjuvant chemotherapy, and long-term follow up data. We performed 23 LITT treatments and 34 craniotomies for recurrent GBM in patients that met selection criteria. There was no significant difference in the patients’ age, tumor volume (6.38 for craniotomy versus 5.765 cc for LITT), location, and post-procedure KPS. Patients that underwent LITT had significantly reduced inpatient stays in comparison to craniotomy (1.7 versus 4.2 days). They also had less perioperative complications (13.0% versus 32.3% for craniotomy). It was found that 28 out of the 34 patients that underwent craniotomy were able to undergo adjuvant therapy; in comparison, 15 out of the 23 patients who underwent LITT had undergone adjuvant therapy. Of these patient’s that underwent adjuvant therapy, 87% of patients were able to receive bevacizumab or a clinical trial versus 42% after craniotomy. Progression-free survival (PFS) and overall survival (OS) after procedure were similar for LITT versus craniotomy, respectively: % PFS-survival at 6 months = 23.5% versus 21.7%. Overall survival did not significantly differ at 9 months versus 9.9 months respectively. LITT appears to be safe and may be as efficacious as craniotomy in achieving progression free survival for small to moderate volume recurrent GBM.

Association of PD-L1 expression with tumor infiltrating immune cells and mutation burden in the high grade neuroendocrine carcinoma of the lung.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 8564-8564 ◽  
Author(s):  
Hye Sook Kim ◽  
Ji-Youn Han
Keyword(s):  
Neuroendocrine Carcinoma ◽  
Immune Cells ◽  
Progression Free Survival ◽  
Large Cell ◽  
High Grade ◽  
Free Survival ◽  
Mutation Burden ◽  
Programmed Death ◽  
Significant Difference

8564 Background: Large cell neuroendocrine carcinoma (LCNEC) and small cell lung cancer (SCLC) are recognized as high grade neuroendocrine carcinoma of the lung and remain among the most fatal malignancies. Programmed death-ligand 1 (PD-L1) is expressed in a group of cancers that may be suitable for specific immunotherapy. We retrospectively investigated PD-L1 expression in tumor cells (TC) and tumor infiltrating immune cells (IC) and correlated this with mutation burden and clinical outcome. Methods: A total of 192 patients with LCNEC (n = 72) and SCLC (n = 120) were explored. PD-L1 expression was scored by immunohistochemistry in TC and IC. We used the Ion AmpliSeq Comprehensive Cancer Panel to identify mutation in all exons in 409 cancer-related genes. Results: The overall prevalence of PD-L1 expression on TC was 15.1 % (29/192). No significant difference was observed between LCNEC and SCLC (16.7% vs. 14.2%, p = 0.365). Tumor-infiltrating IC and PD-L1 positive immune cells (IC) were observed in 34.4% (66/192) and 31.3% (60/192), respectively. The prevalence of tumor-infiltrating IC and PD-L1 expression on IC were significantly higher in LCNEC compared to SCLC (57.6% vs. 23.3%, p < .001; 45.8% vs. 22.5%, p = .001, respectively). Tumor-infiltrating IC and PD-L1 expression on IC were correlated with higher nonsynonymous mutational load (p = 0.048 and 0.038, respectively). Tumor-infiltrating immune cells (median 11.3 vs. 6.8 months, p = 0.005), and its correlated PD-L1 expression on IC (median 11.3 vs. 7.0 months, p = 0.024) were related with better progression free survival. There was no relevance between biomarker status and overall survival. Conclusions: These findings suggest that the PD-1/PD-L1 pathway is activated in a fraction of HGNEC of lung with correlating higher mutational burden. Further studies are needed to determine the PD-L1 expression and correlated clinical features to refine role of anti-PD1 treatments in these patient population.

Expression of CD40 Correlates Negatively with Overall and Progression-Free Survival of Low- and High-Grade Gliomas

2019 ◽  
Vol 130 ◽  
pp. e17-e25
Author(s):  
Jan-Michael Werner ◽  
Saskia Kuhl ◽  
Katharina Ulrich ◽  
Boris Krischek ◽  
Pantelis Stavrinou ◽  
...  
Keyword(s):  
Progression Free Survival ◽  
High Grade ◽  
Free Survival ◽  
High Grade Gliomas

Radical Laser Interstitial Thermal Therapy Ablation Volumes Increase Progression-Free Survival in Biopsy-Proven Radiation Necrosis

2020 ◽  
Vol 136 ◽  
pp. e646-e659 ◽  
Author(s):  
Evan Luther ◽  
David McCarthy ◽  
Ashish Shah ◽  
Alexa Semonche ◽  
Veronica Borowy ◽  
...  
Keyword(s):  
Radiation Necrosis ◽  
Progression Free Survival ◽  
Thermal Therapy ◽  
Free Survival ◽  
Laser Interstitial Thermal Therapy

scholarly journals Laser interstitial thermal therapy for newly diagnosed and recurrent glioblastoma

2016 ◽  
Vol 41 (4) ◽  
pp. E12 ◽  
Author(s):  
Jonathan G. Thomas ◽  
Ganesh Rao ◽  
Yvonne Kew ◽  
Sujit S. Prabhu
Keyword(s):  
Median Survival ◽  
Progression Free Survival ◽  
Primary Brain Tumor ◽  
Recurrent Glioblastoma ◽  
Thermal Therapy ◽  
Newly Diagnosed ◽  
Free Survival ◽  
Laser Interstitial Thermal Therapy ◽  
Median Progression Free Survival ◽  
Recurrent Gbm

OBJECTIVE Glioblastoma (GBM) is the most common and deadly malignant primary brain tumor. Better surgical therapies are needed for newly diagnosed GBMs that are difficult to resect and for GBMs that recur despite standard therapies. The authors reviewed their institutional experience of using laser interstitial thermal therapy (LITT) for the treatment of newly diagnosed or recurrent GBMs. METHODS This study reports on the pre-LITT characteristics and post-LITT outcomes of 8 patients with newly diagnosed GBMs and 13 patients with recurrent GBM who underwent LITT. RESULTS Compared with the group with recurrent GBMs, the patients with newly diagnosed GBMs who underwent LITT tended to be older (60.8 vs 48.9 years), harbored larger tumors (22.4 vs 14.6 cm3), and a greater proportion had IDH wild-type GBMs. In the newly diagnosed GBM group, the median progression-free survival and the median survival after the procedure were 2 months and 8 months, respectively, and no patient demonstrated radiographic shrinkage of the tumor on follow-up imaging. In the 13 patients with recurrent GBM, 5 demonstrated a response to LITT, with radiographic shrinkage of the tumor following ablation. The median progression-free survival was 5 months, and the median survival was greater than 7 months. CONCLUSIONS In carefully selected patients with recurrent GBM, LITT may be an effective alternative to surgery as a salvage treatment. Its role in the treatment of newly diagnosed unresectable GBMs is not established yet and requires further study.

scholarly journals Role of Bevacizumab in High-grade Meningiomas

2021 ◽  
Author(s):  
Xuexue Bai ◽  
xiangyu wang ◽  
Yiyao Cao
Keyword(s):  
Progression Free Survival ◽  
Rank Test ◽  
High Grade ◽  
Chi Square ◽  
Free Survival ◽  
Log Rank Test ◽  
Peritumoral Brain Edema ◽  
Chi Square Test

Abstract Background: To explore the role of bevacizumab (BV) in High-grade Meningiomas (HGMs) undergoing surgical treatment.Methods: Review the clinical data of 139 patients with HGMs and divide them into BV group and non- BV group according to whether they receive BV treatment. Then we compared the progression-free survival (PFS) and overall survival (OS) of the two groups.Results: The Chi-square test showed significant differences between the BV group and the non-BV group in terms of 12-month PFS (PFS-12), 36-month PFS (PFS-36), median PFS (M-PFS), 12-month OS (OS-12), 36-month OS (OS-36), and median OS (M-OS). However, there was no statistical difference between the BV group and the non-BV group in terms of 6-month PFS (PFS-6), 60-month PFS (PFS-60), and 60-month OS (OS-60). The log-rank test indicated significant differences in PFS and OS between the BV group and the non-BV group.Conclusion: The role of BV in patients with HGMs is to relieve the symptoms of peritumoral brain edema (PTBE) and prolong PFS and OS. However, whether increasing the dose of BV after surgery can improve the long-term PFS and OS of patients with HGMs needs further research.

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