Laser Interstitial Thermal Therapy for Brain Tumors: A Prospective Multicenter Analysis of Patients From the LAANTERN Study
Abstract
Background: Laser interstitial thermal therapy is a surgical tool used to ablate brain tumors, radiation necrosis, and epileptic foci. Data from the completed LAANTERN prospective multicenter registry (NCT02392078), containing tumor patients enrolled in the study across 25 US centers between 2015-2023, was analyzed to determine clinical outcomes for patients treated with LITT.Methods: All patients with primary or metastatic brain tumors treated with LITT using the Monteris NeuroBlate® System were included in this analysis. Demographics, intraprocedural data, adverse events, survival data, and data pertaining to functional status over time were prospectively collected and then analyzed. Both univarimethodate and multivariate analyses were performed.Results: Seven-hundred eighty-seven (787) primary (445) and metastatic brain tumor (342) patients were included. Median age was 59.6; 18 pediatric patients were included, median age 15 years. Median length of hospital stay was 32.4 hours and 62.6% avoided ICU admission. The adverse event rate was 12.8%, with 65.5% of events considered transient. Anticonvulsants were stopped in 30-40% of patients and 80% of patients stopped steroids after LITT. QoL neither improved nor worsened out to 3 years after LITT. Greater extent of ablation and smaller lesion size were associated with significant improvements in survival and local control outcomes across most sub-cohorts.Interpretation: The data from this largest prospective LITT cohort to date highlight LITT as an effective treatment option for primary and metastatic tumor patients with short hospital stays, low complication rates, and preserved functional status. Extent of ablation in high-grade gliomas and lesion volume in metastatic disease emerge as key outcome determinants, helping guide patient selection. LITT should be considered early as a first-line treatment option for select patients.Funding LAANTERN study is sponsored by Monteris Medical Corp. ClinicalTrials.gov study ID #NCT02392078.Copyright NeuroBlate® System is owned by Monteris Medical Corp.
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Authors: Eric C. Leuthardt, Veronica Chiang, Patrick Landazuri, Dimitris G. Placantonakis, Steven R. Abram, David Sun, Kris A. Smith, Alireza Mohammadi, Clark C. Chen, Brian J. Williams, David Piccioni, Tiffany R. Hodges, Andrew E. Sloan, Bradley Lega, Analiz Rodriguez, Michel Lacroix, Fedor Panov, Hamid Borghei Razavi, James Baumgartner, Taylor J. Abel, Kathleen Bandt, Matthew D. Smyth, Ganesh Rao, Peter E. Fecci, Adrian W. Laxton, Stephen B. Tatter, Albert H. Kim, Sujit S. Prabhu
Institutions: University of Pittsburgh, Northwestern University, University of Colorado Denver, Icahn School of Medicine at Mount Sinai, University of California San Diego, Johns Hopkins University, University of Arkansas for Medical Sciences, Brown University, Washington University in St. Louis, The University of Texas MD Anderson Cancer Center, Yale University, New York University, Southwestern Medical Center, The University of Texas Southwestern Medical Center, University of Kansas Medical Center, Baylor College of Medicine, AdventHealth Orlando, Wake Forest University, Cleveland Clinic, University Hospitals of Cleveland, University of Louisville, Neurological Surgery, Barrow Neurological Institute, Mount Sinai Hospital, Wright State University, Saint Thomas Health, Norton Healthcare, Geisinger Neuroscience Institute, Mount Sinai Hospital, Mount Sinai Medical Center, Cleveland Clinic Florida, Johns Hopkins All Children's Hospital