Laser interstitial thermal therapy for treatment of post-radiosurgery tumor recurrence and radiation necrosis

Background and objective: Approximately one-third of all intracranial metastatic lesions treated with stereotactic radiosurgery (SRS) will regrow at some point during follow-up. A fraction of these lesions will require further therapy. Traditional approaches will work in a majority of, but not all, cases. Laser interstitial thermal therapy (LITT) represents a promising strategy for treatment of regrowing lesions post-SRS that are refractory to standard therapies. Materials and methods: Published literature to evaluate the role of LITT for treatment of regrowing metastatic lesions post-SRS is reviewed; own single institution experience treating these pathologies with two different commercially available LITT systems is included. Results: Early clinical studies have established that LITT can be used to successfully treat post-SRS regrowing lesions. Patients treated with LITT demonstrate both clinical and radiographic improvements following treatment, with minimal side effects. Conclusions: LITT is a promising new therapy for the management of post-SRS regrowing intracranial metastases. Large-scale clinical trials demonstrating therapeutic efficacy must be completed prior to widespread adoption of this technique.