**Laser Ablation in Neuro-oncology**

Mayur Sharma, Danilo Silva, Suresh Balasubramanian, Gene H. Barnett and Alireza M. Mohammadi

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/62771

#### **Abstract**

[45] Mathews EH, Liebenberg L. Is knowledge of brain metabolism the key to treating highly glycolytic cancers and metastases?. Neuro-oncology. 2013;15(6):649.

[46] Shen H, Hau E, Joshi S, Dilda PJ, McDonald KL. Sensitization of glioblastoma cells to irradiation by modulating the glucose metabolism. Mol Cancer Ther. 2015;14(8):1794.

[47] Agnihotri S, Zadeh G. Metabolic reprogramming in glioblastoma: the influence of cancer metabolism on epigenetics and unanswered questions.Neuro Oncol. 2016;18(2):

[48] Debus J, Abdollahi A. For the next trick: new discoveries in radiobiology applied to glioblastoma. American Society of Clinical Oncology Educational Book. 2014 ASCO Educational Book Errata asco.org/edbook © 2014 American Society of Clinical

160–72.

282 Neurooncology - Newer Developments

Oncology, Alexandria, VA 95–9.

*Laser interstitial thermal therapy* (LITT) has emerged as a potential tool in the armamen‐ tarium of neurosurgeons managing patients with deep-seated and difficult-to-access brain tumors. Advances in stereotactic neurosurgery coupled with neuroimaging tools have led to the resurgence of interest in laser therapy for a variety of neurosurgical indications. Stereotactic placement of laser probe using minimally invasive techni‐ ques and the ability to monitor the tissue ablation in real time using MR thermometry are two distinct advantages of LITT. Patients with recurrent gliobastoma multiforme (GBM) or newly diagnosed gliomas with significant medical comorbidities, radiation necrosis, radiosurgery-resistant brain metastasis and cancer-related pain pose significant challenges in the field of neuro-oncology. LITT offers an opportunity to obtain stereotactic biopsy and cytoreduction in a minimally invasive nature. In this chapter, we have described the current applications of LITT in neuro-oncology, including malignant gliomas, brain metastatic disease, radiation necrosis and other indications such as cancer-related pain and epilepsy. We have also described the principles, technical nuances and LITT systems currently available in the clinical practice. With growing interest and acceptance of LITT in neuro-oncology, we are likely to obtain high-quality evidence supporting the utility of this modality in patients with a variety of neuro-oncological conditions in the near future.

**Keywords:** laser therapy, thermal therapy, gliomas, radiation necrosis, brain metasta‐ sis, epilepsy, cancer pain

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
