Survival outcomes in patients with recurrent glioblastoma treated with Laser Interstitial Thermal Therapy (LITT): A systematic review

Objective: To study the role of laser interstitial thermal therapy in recurrent glioblastoma and to assess its effect in the overall survival and in progression-free survival. Methods: A MEDLINE and Pubmed search was performed for the key words "laser interstitial thermal therapy", "LITT" and "glioblastoma". Studies investigating overall survival and progression-free survival of recurrent glioblastoma after laser interstitial thermal therapy were selected. Results: A total of 17 studies met the selection criteria, accounting for 203 patients with recurrent glioblastoma who underwent 219 laser interstitial thermal therapy treatments. The median age was 57.4 years and there was male predominance (65.8 % male Vs 34.2 % female). The most common location resulted frontal lobe (29 %), followed by temporal (23.9 %), parietal (21.4 %) and occipital lobes (2.6 %). Additional locations included thalamus, corpus callosum and cerebellum (23.1 %). Pre-treatment median tumor size was 8.9 cm3. Morbidity was 6.4 % with a median hospital stay of 3.5 days. The most common complications were seizures (2%), motor deficits (1.5 %), wound infection (1.5 %), transient hemiparesis (1%) and hemorrhage (0.5 %). No deaths were reported due to LITT procedure. The median progression-free survival and the median overall survival after laser interstitial thermal therapy resulted 5.6 months and 10.2 months, respectively. The median overall survival from diagnosis was 14.7 months. All patients underwent adjuvant chemotherapy after treatment. Conclusion: Laser interstitial thermal therapy provides an effective treatment with low morbidity for selected patients harboring recurrent glioblastoma. Laser interstitial thermal therapy should be included in the armamentarium of neurosurgical oncologist for treatment of recurrent glioblastomas.