Laser interstitial thermal therapy for the ablation of pediatric low-grade glioma: a single-institution series of 13 patients.
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PURPOSE: Surgical resection is a mainstay of treatment for pediatric patients with low-grade gliomas (LGG). However, LGG arising in eloquent cortex or in deep-seated regions represent a surgical challenge. Laser interstitial thermal therapy (LITT) has shown efficacy for treating lesions in anatomically or functionally challenging locations. In this study, we describe our experience with using LITT to treat pediatric patients with LGG. METHODS: We performed a single-institution retrospective chart review to identify all patients under age 25 who underwent LITT for the treatment of LGG. Patient demographics, lesion and treatment characteristics, and postoperative clinical and radiographic outcomes were collected. RESULTS: Thirteen pediatric patients with LGG who were treated with LITT (mean volume 2.4 ± 3.7 cc). Lesions were subcortical in the frontal (n = 7; 54%) or parietal (n = 2; 15%) lobes, cerebellar (n = 3; 23%), or thalamic (n = 1; 8%). No technical challenges were noted. In two patients (15%) with large lesions (> 5 cc), two-trajectory LITT was used. A biopsy was performed prior to LITT using the same trajectory in twelve patients (92%). At last follow-up (mean 28mo), 12 patients (92%) experienced no disease progression. One patient experienced progression of disease 3 months after LITT. Two patients (15%) experienced transient neurological deficits, which resolved within 1 month with steroid medication. There were no mortalities or postoperative hemorrhages. CONCLUSION: Pediatric patients with LGG can be safely and effectively treated with LITT. This approach is particularly promising for treating small, deep-seated lesions that are often seen in pediatric patients and can be integrated into the surgical workflow for patients where a lesion biopsy is warranted.