LAUSR

The prognosis of patients diagnosed with recurrent glioblastoma remains dismal, and therapeutic options are limited. The median survival is only 3 to 5 months. Stereotactic laser ablation is a minimally invasive neurosurgical technique used as an ablative treatment. We report outcomes of a large single institutional patient database of recurrent glioblastoma treated with laser ablation. Patients with recurrent glioblastoma, previously treated with biopsy or surgical resection plus standard radiation/temozolomide (and any other additional therapies), who underwent laser ablation with the NeuroBlate system at The Cleveland Clinic were retrospectively reviewed from 2011 through 2017. Primary endpoints were progression free survival (PFS) and overall survival (OS). Between 2011 and 2017, 31 patients with recurrent glioblastoma were treated with laser ablation out of more than 250 laser ablation cases for brain tumors. This population included 17 males and 14 females. Age at the time of diagnosis ranged from 27 to 77. 84% underwent surgical resection as the initial treatment. 65% were treated with laser ablation after the first recurrence of previously treated glioblastoma. The average number of postoperative hospital days was 2.8, and most patients went home. 54% remained neurologically stable without new postoperative deficits, and 52% had no reported change in Karnofsky Performance Scale from before to after laser ablation. Median PFS was 5 months, and median OS was 13 months. Laser ablation has been used to treat various intracranial lesions at The Cleveland Clinic, particularly recurrent glioblastoma. This treatment modality can be utilized at any point of recurrence in patients with appropriate clinical and radiographic characteristics. In addition, the minimally invasive nature and relatively short hospital stay in comparison to surgical tumor resection make laser ablation favorable. Laser ablation is becoming a valuable tool in a multidisciplinary approach to treat recurrent glioblastoma.