The efficacy of laser interstitial thermal therapy for brain metastases with in-field recurrence following SRS: systemic review and meta-analysis

Abstract

Objective To study the efficacy of LITT for BM patients experiencing in-field recurrence following SRS. Methods A literature search was conducted to identify studies investigating local control (LC) rate and overall survival (OS) of LITT for BMs with IFR following SRS. Results Analysis included 14 studies (470 patients with 542 lesions). The 6-month (LC-6) and 12-month (LC-12) local control rates were 78.5% (95% CI: 70.6–84.8%) and 69.0% (95% CI: 60.0–76.7%) separately. Pooled median OS was 17.15 months (95% CI: 13.27–24.8). The overall OS-6 and OS-12 rates were 76.0% (95% CI: 71.4–80.0%) and 63.4% (95% CI: 52.9–72.7%) separately. LITT provided more favorable local control efficacy in RN than BM recurrence (LC-6: 87.4% vs. 67.9%, p = 0.009; LC-12: 76.3% vs. 59.9%, p = 0.041). Conclusions LITT is an effective treatment for BM patients experiencing IFR following SRS. For different pathological entities, LITT showed more satisfactory local control efficacy on RN than BM recurrence.

Keywords

• brain metastases
• radiation necrosis
• litt
• srs
• in-field recurrence
• efficacy