Laser therapy study identifies factors that extend survival for brain tumor patients

Researchers at Washington University School of Medicine in St. Louis have published a prospective multicenter analysis of 787 patients who underwent laser interstitial thermal therapy (LITT) for primary or metastatic brain tumors. The study, known as LAANTERN, tracked outcomes for up to five years across 25 U.S. sites led by Siteman Cancer Center.

The minimally invasive procedure, performed with the FDA-cleared NeuroBlate system, involves drilling a small hole in the skull and inserting a robotically guided laser probe under real-time MRI to heat and destroy tumor tissue. It has been used primarily for recurrent or hard-to-reach tumors since 2009.

For patients with newly diagnosed glioblastoma, the analysis showed that achieving at least 91% tumor ablation was associated with a median survival of 2.1 years from diagnosis. Standard open surgical resection typically yields a median survival of approximately 1.5 years, suggesting LITT could be considered earlier in treatment planning.

For brain metastases treated after prior radiation, the data indicated a survival advantage when laser therapy was applied while tumors were still small. This challenges the common practice of watchful waiting over multiple imaging cycles to confirm growth before intervening.

Beyond survival, the study confirmed quality-of-life benefits. The procedure requires only a few-millimeter incision, limits average hospital stays to 32 hours, and most patients avoided intensive care and readmission. The need for antiseizure medication also decreased compared with pre-surgery levels.

Principal investigator Eric C. Leuthardt, M.D., performed the nation's first LITT for a brain metastasis at Barnes-Jewish Hospital in 2010. He said the findings help identify which patients benefit most from the therapy and support a shift toward lower-risk, faster-recovery approaches for brain tumor care.

The study was published in the Journal of Clinical Oncology. Researchers noted that the prospective design and large cohort provide actionable data for clinical decision-making, though the analysis identifies associations rather than proving causation.