A 65-year-old woman with a small focal recurrence of glioblastoma was treated with laser interstitial thermal therapy (LITT) at UCSF nearly five years after her first tumor resection surgery. The lesion was ablated, and the patient was discharged home the next day.
“One of the major indications for LITT is recurrent disease,” said UCSF neurosurgeon Shawn Hervey-Jumper, MD. “This patient is a long-term survivor of glioblastoma. LITT allowed me to ablate the new lesion effectively with minimal recovery time for her.”
Focal recurrence after two open surgeries
At age 60, the patient presented with a three-month history of declining memory, receptive aphasia and headaches. She was found to have a 4.6-by-5.4-by-4-centimeter contrast-enhancing mass in her temporal lobe. Hervey-Jumper and the UCSF neurosurgical team removed the tumor, which was confirmed to be a glioblastoma. The patient was treated with radiation and temozolomide for six months and also participated in a nivolumab clinical trial.
“She did well for a year and a half, but then she had disease progression,” said Hervey-Jumper. “The tumor started to grow back.” The team performed a second resection surgery and the patient underwent 12 six-week cycles of temozolomide plus olaparib. Five months after the treatment concluded, a 1-by-1.5-by-1.3-centimeter focal recurrence was detected during routine monitoring.
Minimally invasive procedure
“She had good performance status but was frail,” said Hervey-Jumper. “Recovering from another open surgery would have been difficult for her. We discussed her case at our tumor board and came up with LITT as an appropriate focal ablative option.”
During the procedure, he and the team used intraoperative MRI to guide a laser through a thin catheter to the lesion. LITT requires only a small incision. Sensors in the MRI system allowed them to detect the thermal energy being delivered to ensure accurate ablation of the tumor. The surgery took less than four hours, and the patient was discharged home the next morning. In the six months since receiving LITT, she has had no disease recurrence.
“LITT is a very useful tool for cases like this one,” said Hervey-Jumper.
Neurology and neurosurgery research and treatment take place within the UCSF Weill Institute for Neurosciences.
Cancer research and treatment take place within the UCSF Helen Diller Family Comprehensive Cancer Center.
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