Minimally invasive laser hyperthermia in the complex treatment of local continued growth of glioblastomas (pilot study)

SUMMARY. Minimally invasive cytoreductive operations are relevant for surgery of cerebral malignant gliomas. Stereotactic laser hyperthermia is the most common cytoreductive operation for intracerebral tumors.

THE PURPOSE OF THE STUDY: to evaluate the efficacy and safety of the developed original method of minimally invasive laser hyperthermia for the treatment of local recurrence of glioblastomas.

MATERIALS AND METHODS: 16 patients with recurrent glioblastomas were operated on using minimally invasive laser hyperthermia (MILH). Aiming at the tumor was carried out using the neuronavigation station Medtronic 7. The average age was 48 years. Localization of tumors is supratentorial. Relapses with multifocal growth were 75 %. The average tumor volume is 4.0 cm3. Score on the Karnofsky scale (KPS) at admission 78.1 b. Operations were performed in the neurosurgical department of the St. Petersburg State Medical University. acad. I. P. Pavlova. Survival has been tracked.

RESULTS. Duration of MILH operation 143 min. Total hyperthermia was performed in 56.3 %, in all the rest — subtotally 43.7 %. KPS after surgery in the MILH group was 78.8 bp. Survival in the MILH group after laser surgery was 10 months, overall survival was 26 months. Postoperative mortality 0 %. Most patients were discharged within 5 days after surgery.

CONCLUSION. MILH is a low-traumatic, effective and safe cytoreductive operation that allowed to reduce the volume of a recurrent tumor and achieve a postoperative survival of 10 months. Stable KPS status and easy tolerability of surgery by patients, short postoperative bed-day allow to quickly continue antitumor treatment. MILH is considered for patients with recurrent GBM, especially those with deep localization, in whom open reoperation is associated with high risks. The relevance of MILH increases in recurrent GBM with a molecular genetic profile suggesting resistance to standard anticancer treatment, as well as in the presence of residual tumor.

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