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

Image-guided LITT as a minimal invasive procedure in the treatment of callosa gliomas

MR gesteuerte LITT als minimal-invasive Methode in der Behandlung von Balkengliomen

Meeting Abstract

  • corresponding author W. von Tempelhoff - Department of Neurosurgery, Klinikum Krefeld, University of Düsseldorf, Medical School at Krefeld
  • H. Niehoff - Department of 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. U. Fiedler - Department of Radiology, Klinikum Krefeld, University of Düsseldorf, Medical School at Krefeld
  • F. Ulrich - Department of 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. DocP187

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0455.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 majority of gliomas affecting the corpus callosum are classified as bein unsuitable for open microsurgery. Depending on the neuropathological findings of a stereotactic biopsy, there is no therapeutic option for the benign tumors; malignant gliomas receive radiation and chemotherapy as a palliative standard. As a new option of minimal invasive therapy, we introduced the MR-guided laser-induced interstitial thermotherapy (LITT) for these cases. It offers a relatively safe method of partial cytoreduction in the region of corpus callosum. A (palliative) reduction of tumor growth can be achieved. As examples for the application of LITT in benign and malignant gliomas affecting the corpus callosum, two patients are demonstrated:

- A 42-year-old woman with a benign astrocytoma (II° WHO) of the anterior and middle parts of the corpus callosum was treated in 1999 (Karnofsky Index 100)

- A 56-year-old woman with a recurrent glioblastoma of the posterior corpus callosum was treated three times in 2003; a simultaneous chemotherapy (temozolomide) was added and repeated monthly.

Methods

Laser irradiation was performed using a Nd:YAG laser (1064 nm). The light was transmitted via a light guide ending in an optical diffusion tip which was positioned in the centre of the tumor. The mean energy delivered per laser session was 4.5±0.7 kJ. Laser therapy was guided by MR-imaging. For the positioning of the light guide, a special localization system 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 tumors.

Results

LITT was tolerated well without major complications. The benign glioma (astrocytoma II° WHO), treated once in '99, showed a stepwise change of its whole inner structure in the MR-follow-up during more than five years. A minor paresis of the hand even vanished. The primarily fast-growing, radiated glioblastoma of the posterior corpus callosum was treated three times in 2000; the tumor growth stopped, a partial cytoreduction was achieved for 9 months, the patient died from a general infection under corticoids 10 months after the first "LITT".

Conclusions

The LITT can be used as a safe and repeatable minimal invase therapy in "non-surgical candidates" suffering from benign and malignant gliomas affecting the corpus callosum. Survival time can be increased, preserving a good quality of life.