A new study has shown that laser treatment in the fight against brain tumors may help prolong patients' lives and improve their quality of life, especially when used early.
Researchers at Washington University School of Medicine in St. Louis reached these conclusions after analyzing data from 787 patients who underwent laser treatment in a multicenter clinical trial that followed patients for up to five years. The study included 25 medical centers in the United States, led by the Washington University Siteman Cancer Center.
This treatment is known as laser interstitial thermotherapy (LITT), and is used especially with patients suffering from recurrent brain tumors or tumors that are difficult to access or cannot be removed by conventional surgery.
Patients with glioblastoma, one of the most aggressive forms of brain cancer, usually undergo open surgery that requires the removal of part of the skull to access and excise the tumor, and this may be followed by chemotherapy and radiation therapy.
Laser treatment, on the other hand, requires making a small incision in the skull to insert a thin probe into the tumor. Surgeons use real-time MRI to precisely guide the probe through the brain, avoiding healthy tissue as much as possible.
After the probe reaches the tumor, the laser uses heat to destroy the surrounding cancer cells.
Monteris Medical developed the NeuroBlet device used in this procedure, and the device received FDA approval for marketing in 2009.
"Our goal is to extend the survival time of brain tumor patients and improve their quality of life," said Dr. Eric C. Liothardt, the study's lead researcher and professor of neurosurgery at Washington University School of Medicine in St. Louis.
He added that the study's findings help doctors identify factors associated with optimal outcomes, potentially allowing patients to benefit more from treatment.
The researchers focused on identifying factors that could influence the success of the treatment, and found that the percentage of tumors destroyed by the laser is clearly related to the length of time patients survive.
This association was particularly evident in patients newly diagnosed with glioblastoma.
The analysis showed that patients whose tumors were destroyed by the laser in at least 91% of cases lived an average of 2.1 years from the date of diagnosis. The average survival rate after traditional open surgery is approximately 1.5 years.
The researchers believe that these results open the door to studying the use of laser therapy early in the treatment course for glioblastoma, rather than limiting it to recurrent cases or those that are difficult to treat with traditional surgery.
The study also included patients with brain metastases, which are tumors that spread to the brain from cancer that has affected another organ in the body.
The data showed that patients who underwent laser treatment when the metastases were still small achieved better survival rates, suggesting that early intervention may be more beneficial than waiting until the tumor grows.
These results may prompt a reconsideration of the monitoring approach used by doctors in some cases, where the patient undergoes repeated rounds of MRI scans to monitor the tumor before a decision is made regarding therapeutic intervention.
The benefits of laser treatment identified by the study were not limited to survival, but also included recovery period and quality of life.
While traditional surgery requires opening the skull, and the patient may need weeks to recover afterwards, laser treatment requires only a small opening in the skull and closing it with a single stitch.
The study data showed that patients tolerated the procedure well, maintaining their ability to carry out their daily activities, and the average hospital stay was only about 32 hours.
Most patients recovered quickly, and the majority did not require admission to the intensive care unit or readmission to the hospital. Their need for epilepsy medication also decreased compared to the period before the procedure.
Leuthardt said this approach changes the way brain tumors are treated, adding that providing a low-risk treatment that allows the patient to return home to their family in just one day is of great importance, especially for those facing a difficult diagnosis and limited survival prospects.
Researchers continue to study the best ways to identify patients who can benefit most from laser treatment, as well as the optimal timing for its use, with the aim of improving survival rates and maintaining quality of life at the same time.
