A U.S. neurosurgeon recently compiled data from hundreds of patients with glioblastoma and brain metastases. These patients were treated across several hospital centers with a specific technique: Laser Interstitial Thermal Therapy (LITT). While the results appear promising, the technique also carries some constraints.
A Promising Surgical Technique
First, let us note that glioblastoma is the most aggressive and common primitive brain cancer in adults. This malignancy, classified by the World Health Organization (WHO) as a grade 4 malignant tumor, develops rapidly from glial cells, the brain’s nourishing cells. Regarding brain metastases, these are secondary brain tumors. They do not originate directly in the brain but arise from cancer cells that have spread from another organ.
As revealed in a publication in the Journal of Clinical Oncology dated August 17, 2026, a surgical technique—Laser Interstitial Thermal Therapy (LITT)—could improve survival for patients with glioblastoma and brain metastases. The neurosurgeon Eric C. Leuthardt of the Siteman Cancer Center in St. Louis (United States) compiled data from 787 patients treated at 25 U.S. centers between 2015 and 2023.
“The data from this large prospective cohort of patients treated with LITT support the use of this technique as a cytoreductive tool for both primary and metastatic tumors, while enabling short hospital stays, a low complication rate, and the preservation of functional status.”
How LITT Works
In practice, LITT is a minimally invasive surgical technique. It uses the heat produced by a laser to destroy cancer cells from within the tumor, while protecting surrounding healthy brain tissue. The procedure begins with a high-precision MRI to map the tumor in 3D. Subsequently, the neurosurgeon creates a skull opening of about 2 mm in diameter and inserts a fine optical fiber into the tumor, surrounded by a cooling sheath. Once the probe is in place, the laser is activated, and the light transforms into thermal energy within the tissue. At temperatures between 43 and 59°C, cellular proteins begin to denature and the cancer cell membranes are damaged. At temperatures above 60°C, cell death occurs almost instantly through coagulative necrosis. Consequently, the tumor tissue literally cooks and is completely destroyed.
Interestingly, the patient remains inside the MRI for the entire procedure, so the device can provide a real-time color thermal map of the brain. The system then computes the thermal dose delivered to the tissues second by second to ensure that the heat does not spill into critical brain areas, including language centers and motor regions.
Results That Offer Hope Despite a Few Constraints
Eric C. Leuthardt’s findings are encouraging. The study indicates that the effectiveness of LITT hinges critically on the extent of ablation—the percentage of tumor mass destroyed by heat (EOA). For glioblastoma, achieving an ablation of more than 91% of the tumor improves median overall survival by 2.1 years compared with patients who had an ablation below 90%. For brain metastases, achieving 100% ablation yields a median overall survival of 2.8 years, versus 1.3 years when ablation is below 99%.
Thus, LITT offers several advantages: it is minimally invasive, effective, shortens hospital stays, has a low complication rate, and preserves functional status. Moreover, the technique is transformative for patients who are not suitable for open craniotomy, such as those with deep-seated tumors or a frail overall condition.
Nevertheless, the analysis notes certain constraints, notably limitations when dealing with very large tumors. In fact, achieving an ablation of at least 91% is markedly more challenging when the lesion volume exceeds 15 to 20 cubic centimeters. The technique is therefore considerably more effective for smaller tumors. Another constraint concerns newly diagnosed glioblastomas: early LITT must be combined with radiotherapy and chemotherapy to maximize survival chances.
