**8. Use of LITT in other intracranial tumors**

Jethwa et al. [63] reported the application of Visualase laser system in 20 patients (33 proce‐ dures) with a variety ofintracranial tumors over a period of 1 year. GBM was the most common pathology treated (*n* = 6), followed by metastasis (*n* = 4), ependymoma (*n* = 3), meningioma (*n* = 2), hemangioblastoma (*n* = 2), anaplastic astrocytoma (*n* = 1), chordoma (*n* = 1) and supratentotrial primitive neuroectodermal tumor (*n* = 1) in this study. LITT was considered primarily in patients with failed priortreatment (10 out of 20), in surgically inaccessible areas (*n* = 3), patient preference (*n* = 3) or in those in who conventional surgery was considered high risk (*n* = 4) [63]. Majority of patients were treated with single laser application; however, two patients with GBM, one each with metastasis, meningioma, ependymoma underwent two applications and one patient with GBM required three laser applications to cover the tumor volume. One patient each with ependymoma and GBM underwent staged LITT procedure 2 months apart and one with supratentotrial primitive neuroectodermal tumor underwent repeat procedure due to tumor recurrence. The average tumor volume and average tumor diameter treated was 7.0± 9.0 cm3 and 2.4± 0.85 cm. The average ablation time was 13.9± 10.7 min and median hospital stay of 24 h (average stay of 2.27 days) in this study [63]. It was noted in the study that LITT was welltolerated in the majority of patients with four procedure-related complications. Inaccurate placement of laser probe (patient with cerebellum hemangioblasto‐ ma), placement-related hemorrhage (nearright sylvian fissure meningioma), pituitary thermal injury (pediatric patient with third ventricle recurrent ependymoma) and significant peripro‐ cedural edema (patient with GBM) were reported following 33 LITT procedures in 20 patients. All these complications except pituitary thermal injury required open surgical procedure. Tumor control rates and follow-up imaging were not reported in this study. Another group reported the use of LITT in six patients with intracranial tumors (metastasis, *n* = 4; pituitary prolactinoma, *n* = 1; medullary ependymoma) and one patient with conus ependymoma [129]. Complete ablation was achieved in six out of seven patients and no procedure-related adverse effects were noted in these patients [129]. No long-term outcomes and follow-up results were reported following LITT forthese tumors. Recently, Patel et al. [98] reported the utility of LITT using Visualase system in patients with a variety of intracranial tumors such as meningioma (*n* = 2), ependymoma (*n* = 3), hemangioblastoma (*n* = 2), primitive neuroectodermal tumor (*n* = 3), cavernoma (*n* = 2), chordoma (*n* = 1), teratoma (*n* = 1), CNS lymphoma (*n* = 1) and pineal tumor (*n* = 1) [98]. Total operative time and ablation time were 2.8±0.6 hrs and 8.7±8.1 mins, respectively, in all patients with intracranial tumors including glial tumors (GBM, ganglio‐ glioma, pilocytic astrocytoma). Postoperative complications such as neurological worsening (*n* = 7), hemorrhage (*n* = 2), edema (*n* = 4), infection (*n* = 1), inaccurate catheter placement (*n* = 2) and two deaths following LITT were reported [98]. A major limitation of this study was that outcomes including tumor control rates and recurrence were not reported in this study [98]. The procedure was not completed in two patients, one with recurrent meningioma due to hemorrhage during probe insertion which required emergent evacuation and the second patient with hemangioblastoma had inaccurate placement of laser probe which led to abortion of the procedure.
