Magnetic resonance imaging-guided laser interstitial thermal therapy for posterior fossa lesions: A systematic review with exploratory single-arm meta-analysis.
4 affiliations
- 1Department of Neurosurgery, Universidad Panamericana, Mexico City, Mexico.
- 2Department of Medicine, Tecnológico de Monterrey, School of Medicine and Health Sciences, Guadalajara, Mexico.
- 3Department of Medicine, Universidad Panamericana, Mexico City, Mexico.
- 4Department of Neurosurgery, Centro Médico Nacional Siglo XXI, Mexico City, Mexico.
Abstract
Background
Laser interstitial thermal therapy (LITT) is an emerging, minimally invasive, magnetic resonance imaging (MRI)-guided ablative technique for deep-seated primary brain tumors, brain metastases, and radiation necrosis. Although supportive data exist for select supratentorial indications, its efficacy and safety profile in the posterior fossa remains uncertain.Methods
PubMed, Embase, Scopus, Google Scholar, and the Cochrane Library, including Cochrane Central Register of Controlled Trials, were searched for studies reporting outcomes of LITT in the posterior fossa. Heterogeneity was assessed using the I² statistic, and pooled estimates were calculated using a random-effects model.Results
Nine studies comprising 99 patients with 102 posterior fossa lesions were included in the study. Follow-up varied across studies, ranging from 3.5 to 31.2 months. Lesion-level local control was 79.3% (95% confidence interval [CI]: 57.1-91.6). In stratified analyses, local control was 82.4% (95% CI: 72.1-89.5) for neoplastic lesions and 88.4% (95% CI: 75.0-95.1) for brain metastases. At the patient level, 7.5% (95% CI: 3.4-15.7) required salvage local therapy. Safety outcomes were as follows: persistent neurologic deficit 10.1% (95% CI: 5.4-18.3); all-cause mortality 8.3% (95% CI: 3.3-19.4); and procedure-related mortality 1.0% (95% CI: 0.1-6.8).Conclusion
In patients with posterior fossa lesions, LITT may provide meaningful lesion-level local control with an acceptable safety profile. Given the limited and heterogeneous evidence, these pooled estimates should be interpreted as exploratory rather than definitive. Selective use in surgically complex or treatment-refractory cases following multidisciplinary evaluation may be reasonable. Prospective multicenter studies with standardized endpoints and longer follow-up are needed to establish durability and refine indications.
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BibTeX
@article{elias2026magnetic,
title = {{Magnetic resonance imaging-guided laser interstitial thermal therapy for posterior fossa lesions: A systematic review with exploratory single-arm meta-analysis.}},
author = {José Eduardo Trejo Elías and Arturo Trejo Elías and Ricardo Trejo Elías and César Andrés Valenzuela-Iribe and Andrés Márquez Luján and André Méndez Bolaños Cacho and Victor Ramzes Chavez-Herrera},
journal = {Surgical neurology international},
year = {2026},
month = oct,
doi = {10.25259/sni_520_2026},
url = {https://europepmc.org/article/MED/42974279},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - Magnetic resonance imaging-guided laser interstitial thermal therapy for posterior fossa lesions: A systematic review with exploratory single-arm meta-analysis.
AU - José Eduardo Trejo Elías
AU - Arturo Trejo Elías
AU - Ricardo Trejo Elías
AU - César Andrés Valenzuela-Iribe
AU - Andrés Márquez Luján
AU - André Méndez Bolaños Cacho
AU - Victor Ramzes Chavez-Herrera
PY - 2026
DA - 2026/10/30
JO - Surgical neurology international
DO - 10.25259/sni_520_2026
UR - https://europepmc.org/article/MED/42974279
AB - Background Laser interstitial thermal therapy (LITT) is an emerging, minimally invasive, magnetic resonance imaging (MRI)-guided ablative technique for deep-seated primary brain tumors, brain metastases, and radiation necrosis. Although supportive data exist for select supratentorial indications, its efficacy and safety profile in the posterior fossa remains uncertain.Methods PubMed, Embase, Scopus, Google Scholar, and the Cochrane Library, including Cochrane Central Register of Controlled Trials, were searched for studies reporting outcomes of LITT in the posterior fossa. Heterogeneity was assessed using the I² statistic, and pooled estimates were calculated using a random-effects model.Results Nine studies comprising 99 patients with 102 posterior fossa lesions were included in the study. Follow-up varied across studies, ranging from 3.5 to 31.2 months. Lesion-level local control was 79.3% (95% confidence interval [CI]: 57.1-91.6). In stratified analyses, local control was 82.4% (95% CI: 72.1-89.5) for neoplastic lesions and 88.4% (95% CI: 75.0-95.1) for brain metastases. At the patient level, 7.5% (95% CI: 3.4-15.7) required salvage local therapy. Safety outcomes were as follows: persistent neurologic deficit 10.1% (95% CI: 5.4-18.3); all-cause mortality 8.3% (95% CI: 3.3-19.4); and procedure-related mortality 1.0% (95% CI: 0.1-6.8).Conclusion In patients with posterior fossa lesions, LITT may provide meaningful lesion-level local control with an acceptable safety profile. Given the limited and heterogeneous evidence, these pooled estimates should be interpreted as exploratory rather than definitive. Selective use in surgically complex or treatment-refractory cases following multidisciplinary evaluation may be reasonable. Prospective multicenter studies with standardized endpoints and longer follow-up are needed to establish durability and refine indications.
SN - 2229-5097
SN - 2152-7806
ER -