gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Laser-induced interstitial thermotherapy of recurrent glioblastomas

Laser induzierte interstitielle Thermotherapie von Glioblastomrezidiven

Meeting Abstract

  • corresponding author W. von Tempelhoff - Department of Medical Neurosurgery, Klinikum Krefeld, University of Düsseldorf Medical School at Krefeld
  • H. Niehoff - Department of Medical Neurosurgery, Klinikum Krefeld, University of Düsseldorf Medical School at Krefeld
  • H.-J. Schwarzmaier - Department of Medical Technology, Klinikum Krefeld, University of Düsseldorf Medical School at Krefeld
  • V. Fiedler - Department of Radiology, Klinikum Krefeld, University of Düsseldorf Medical School at Krefeld
  • F. Ulrich - Department of Medical Neurosurgery, Klinikum Krefeld, University of Düsseldorf Medical School at Krefeld

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc11.05.-05.04

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0189.shtml

Veröffentlicht: 4. Mai 2005

© 2005 von Tempelhoff et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

The prognosis of a recurrent glioblastoma is poor. Although new chemotherapy regimens have recently been introduced, the mean survival of these patients is reported to be not longer than three to five months. Therefore, new therapies are required. In this study, we employed laser-induced interstitial thermotherapy (LITT) for a partial cytoreduction in these patients.

Methods

In total, 16 Patients (mean age 62±5.7 yrs) were treated by interstitial laser irradiation. All patients suffered from a histologically confirmed recurrent glioblastoma grade WHO IV and were non-surgical candidates. In all patients, at least one laser treatment was performed. Laser irradiation was performed using a Nd:YAG laser (?=1064 nm, cw, 4060 N, Dornier Medizintechnik, Germering, Germany). The light was transmitted via a light guide ending in an optical diffusion tip (LITT Standard-Applicator, Trumpf, Umkirch, Germany) which was positioned in the centre of the tumour. The mean energy delivered per laser session was 4.5±0.7 kJ. Laser therapy was guided by MR-imaging (SIGNA SP/I, General Electric, Milwaukee, WI). For the positioning of the light guide, the built in localization system (Flashpoint 3000, IGT, Boulder, CO) was used. Thermal therapy was guided by MR thermometry using an experimental software package based on the phase shift technique. Follow-up MR examinations exhibited a volume decrease of the irradiated parts of the tumours.

Results

All patients tolerated the procedure well and there was no in-hospital mortality. Major complications were not observed. Minor complications were a transient paresis in 3 cases. The mean survival of the patients was 9.2 months after the diagnosis of a recurrent glioblastomas and 6.8 months after the first LITT. The cause of death was in most cases related to pulmonary embolism and adverse effects of chemotherapy and/or corticosteroids.

Conclusions

Partial cytoreduction using LITT is feasible and safe in recurrent glioblastoma multiforme. The data showed a tendency towards an increased survival. However, controlled clinical trials are required to define the role of LITT in the clinical management of recurrent glioblastoma.