Laser interstitial thermotherapy may be a substitute for surgery in treating spinal metastasis
Early evidence shows spinal laser interstitial thermotherapy can provide local control, low mortality and improved outcomes in patients with a spinal metastasis, and the treatment may provide an alternative to separation surgery before spinal stereotactic radiosurgery.
In this study, researchers used spinal laser interstitial thermotherapy (SLITT) as an alternative to surgery and used this treatment prior to spinal stereotactic radiosurgery (SSRS). Investigators assessed patients’ pre- and post-surgery VAS scores for pain and quality of life 30 days to 60 days after the procedure. The maximum thickness of the tumors was measured, in addition to the degree of epidural spinal cord compression using pre- and post-procedure MRI. All patients received postoperative SSRS, the authors wrote.
Eleven patients were treated with SLITT. A laser probe was percutaneously placed in the epidural space of the patients, and a real-time thermal MRI was used to monitor tissue damage.
The researchers found VAS scores decreased from 6.18 in the preoperative period to 4.27 within 30 days and 2.8 within 60 days. The percentage of quality of life improved from 60% preoperatively to 70% within 30 days to 60 days after treatment. The average epidural tumor thickness had a statistically significant decrease from 8.82 mm prior to treatment to 6.36 mm as evidenced by 2-month follow-up images.
Researchers concluded SLITT provided low surgical morbidity and had a low impact on quality of life.
“We believe this procedure can be an alternative to separation surgery in patients without neurological deficits prior to SSRS, especially in cases with progressive systemic disease, in which conventional surgery would pose a high risk for complications and lead to an interruption of or delays in the delivery of the intended oncological treatment,” they wrote. – by Robert Linnehan.
Disclosures: Tatsui reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.