Work

Towards the definition of progressive disease in brain metastasis treated with laser ablation: an evidence-based study

Year: 2023

Type: article

Abstract: Purpose The postoperative period after laser interstitial thermal therapy (LITT) is marked by a temporary increase in volume, which can impact the accuracy of radiographic assessment. The current criteria for progressive disease (PD) suggests that a 20% increase in size of brain metastasis (BM) assessed in 6–12 weeks intervals should be considered as local progression (LP). However, there is no agreement on how LP should be defined in this context. In this study, we aimed to statistically analyzed which variations in tumor volume were associated with LP. Methods We analyzed 42 BM that underwent LITT between 2013–2022. For this study, LP was defined following radiographic features, while PD with a combined clinical and radiographic criterion. A ROC curve was generated to evaluate volume change as a predictor of LP and find the optimal cutoff point. A logistic regression analysis and Kaplan Meier curves were performed to assess the impact of various clinical variables on LP. Results Out of 42 lesions, 12 (26.7%) had LP. An increase in volume of 25.6% from baseline within 120–180 days after LITT presented a 70% sensitivity and 88.9% specificity for predicting LP (AUC: 0.78, p = 0.0412). The multivariate analysis showed a 25% increase in volume between 120–180 days as a negative predictive factor (p = 0.007). Volumetric changes within 60–90 days after LITT did not predict LP (AUC: 0.57; p = 0.612). Conclusion Volume changes within the first 120 days after the procedure are not independent indicators of LP of metastatic brain lesions treated with LITT.

Source: Journal of Neuro-Oncology

DOI: 10.1007/s11060-023-04360-0