Laser Interstitial Thermal Therapy for Posterior Fossa Lesions: A Systematic Review and Analysis of Multi-Institutional Outcomes

SIMPLE SUMMARY: Laser interstitial thermal therapy (LITT), a minimally invasive stereotactic treatment option, is emerging as a viable treatment option for deep-seated primary and metastatic brain lesions due to the use of real-time magnetic resonance thermography. LITT has been used with good outcomes for a variety of brain lesions. However, LITT for posterior fossa lesions remains understudied. Currently, there are no treatment recommendations for the LITT of the posterior fossa due to a limited pool of data. In this study, we analyze multi-institutional outcomes of LITT for the treatment of posterior fossa lesions based on the demographics of the samples, including age and gender distribution, tumor pathology, presence or absence of prior treatment, tumor volume assessment, and complications; discuss current results; and suggest areas of future study. ABSTRACT: Background: Laser interstitial thermal therapy (LITT) has emerged as a treatment option for deep-seated primary and metastatic brain lesions; however, hardly any data exist regarding LITT for lesions of the posterior fossa. Methods: A quantitative systematic review was performed. Article selection was performed by searching MEDLINE (using PubMed), Scopus, and Cochrane electronic bibliographic databases. Inclusion criteria were studies assessing LITT on posterior fossa tumors. Results: 16 studies comprising 150 patients (76.1% female) with a mean age of 56.47 years between 2014 and 2021 were systematically reviewed for treatment outcomes and efficacy. Morbidity and mortality data could be extracted for 131 of the 150 patients. Death attributed to treatment failure, disease progression, recurrence, or postoperative complications occurred in 6.87% (9/131) of the pooled sample. Procedure-related complications, usually including new neurologic deficits, occurred in approximately 14.5% (19/131) of the pooled sample. Neurologic deficits improved with time in most cases, and 78.6% (103/131) of the pooled sample experienced no complications and progression-free survival at the time of last follow-up. Conclusions: LITT for lesions of the posterior fossa continues to show promising data. Future clinical cohort studies are required to further direct treatment recommendations.