BACKGROUND: The value of maximal safe cytoreductive surgery in recurrent 
high-grade gliomas (HGGs) is gaining wider acceptance. However, patients may 
harbor recurrent tumors that may be difficult to access with open surgery. Laser 
interstitial thermal therapy (LITT) is emerging as a technique for treating a 
variety of brain pathologies, including primary and metastatic tumors, radiation 
necrosis, and epilepsy.
OBJECTIVE: To review the role of LITT in the treatment of recurrent HGGs, for 
which current treatments have limited efficacy, and to discuss the possible role 
of LITT in the disruption of the blood-brain barrier to increase delivery of 
chemotherapy locoregionally.
METHODS: A MEDLINE search was performed to identify 17 articles potentially 
appropriate for review. Of these 17, 6 reported currently commercially available 
systems and as well as magnetic resonance thermometry to monitor the ablation 
and, thus, were thought to be most appropriate for this review. These studies 
were then reviewed for complications associated with LITT. Ablation volume, 
tumor coverage, and treatment times were also reviewed.
RESULTS: Sixty-four lesions in 63 patients with recurrent HGGs were treated with 
LITT. Frontal (n = 34), temporal (n = 14), and parietal (n = 16) were the most 
common locations. Permanent neurological deficits were seen in 7 patients (12%), 
vascular injuries occurred in 2 patients (3%), and wound infection was observed 
in 1 patient (2%). Ablation coverage of the lesions ranged from 78% to 100%.
CONCLUSION: Although experience using LITT for recurrent HGGs is growing, 
current evidence is insufficient to offer a recommendation about its role in the 
treatment paradigm for recurrent HGGs.
ABBREVIATIONS: BBB, blood-brain barrierFDA, US Food and Drug AdministrationGBM, 
glioblastoma multiformeHGG, high-grade gliomaLITT, laser interstitial thermal 
therapy.