Professional Statements and Societal Positions Guidelines
American Association of Neurological Surgeons and Congress of Neurological Surgeons 2021
In September 2021, the American Association of Neurological Surgeons (AANS) and Congress of Neurological Surgeons (CNS) Joint Section on Tumors issued a position statement regarding the use of LITT for brain tumors and radiation necrosis. The statement concludes that 'LITT is an appealing option because it offers a method of minimally invasive, targeted thermal ablation of a lesion with minimal damage to healthy tissue. There is a growing body of evidence to demonstrate that LITT is an effective and well tolerated cytoreductive option for treatment of [newly diagnosed glioblastoma multiforme (GBM), recurrent GBM, and primary or recurrent brain metastases.] Intracranial LITT is also an effective option for addressing radiation necrosis with an overall reduction in steroid dependence for these individuals. Especially in instances where the therapeutic window is narrowed such that craniotomy is not a viable option, LITT can play an important role in treatment for glioma or metastatic brain cancer.'
American Society for Stereotactic and Functional Neurosurgery 2021
In September 2021, the American Society for Stereotactic and Functional Neurosurgery (ASSFN) issued a position statement on the use of LITT in drug-resistant epilepsy. The statement recommends consideration of MR-guided LITT (MRgLITT) as a treatment option when all of the following criteria are met:
- 'Failure to respond to, or intolerance of, at least two (2) appropriately chosen medications at appropriate doses for disabling, localization-related epilepsy AND
- Well-defined epileptogenic foci or critical pathways of seizure propagation accessible by MRgLITT.'
National Comprehensive Cancer Network 2021
The National Comprehensive Cancer Network (NCCN) clinical practice guidelines for central nervous system cancers (v.2.2021) states that MRI-guided laser interstitial thermal therapy 'may be considered for individuals who are not surgical candidates (craniotomy or resection). Potential indications include relapsed brain metastases and radiation necrosis.' (Category 2B)