Abstract
BACKGROUND
The confluence of laser interstitial thermal therapy (LITT) with immunotherapeutic approaches represents a promising avenue for the management of recurrent brain metastases and glioblastoma. However, the potential synergy between these modalities prompts a thorough examination of their adverse effects. This meta-analysis seeks to evaluate the literature to elucidate the adverse effects associated with the combined use of LITT and immunotherapy in treating recurrent gliomas.
METHODS
Thorough systematic searches were performed on PubMed, Embase, and Web of Science databases using predefined search terms to identify pertinent studies. Inclusion criteria comprised case-control studies, cohort studies, and randomized controlled trials investigating the combined utilization of laser interstitial thermal therapy (LITT) with immunotherapy, among adult patients diagnosed with recurrent brain metastases and recurrent glioblastoma. Our analysis specifically targeted adverse events (AEs) as the primary outcome of interest.
RESULTS
Our systematic review included four studies, including one randomized controlled trial (RCT), one case-control study, and two prospective cohort studies, with a total of 162 patients. Utilizing a random effects model in STATA, we performed a single-arm analysis of adverse events experienced by 56 patients across 3 studies and reported the combination of LITT with immunotherapy for managing recurrent gliomas demonstrated no significant proportion of adverse effects (Proportion= 0.11, 95% CI= -0.02-0.25, P=0.09).
CONCLUSION
When evaluating adverse effects, the combined approach of LITT with immunotherapy in managing recurrent brain metastases and glioblastoma showed no notable significant percentage of patients incurring adverse events, thereby implying a potential comparable safety profile to conventional treatment modalities. However, further research is warranted to test differences in the incidence of adverse events from LITT with immunotherapy versus a control.
Keywords: LITT, immunotherapy, brain cancer, systematic review, meta-analysis