ID #1011 Durable Local Tumor Control Following Laser Interstitial Thermal Therapy (LITT) in Pediatric Neuro-Oncology
Mohamad Bakkar, Nabeel Sumbal, Lara Rostomian, Deniz Altinok, Neena Marupudi, Hamza GorsiAbstract
Background
Laser interstitial thermal therapy (LITT) is an image-guided, minimally invasive ablative technique increasingly used for deep-seated or eloquently located pediatric brain tumors where open resection carries substantial morbidity. While LITT is well described in adult neuro-oncology, pediatric data remains limited particularly across several tumor histologies and cancer-predisposition syndromes. We report institutional outcomes of LITT in a heterogeneous pediatric neuro-oncology cohort, with emphasis on tumor control and clinical course.
Methods
A retrospective review identified all patients ≤21 years with CNS tumors who underwent LITT at Children’s Hospital of Michigan between January 2019 and December 2025. Demographic, clinical, radiographic, syndromic, and longitudinal outcome data were collected from the electronic health record using a standardized collection tool including serial volumetric MRI assessment at baseline, 1, 3, 6, and 12 months, and last follow-up.
Results
Fifteen patients (10 male, 5 female) underwent LITT with diverse pathologies including subependymal giant cell astrocytoma (n = 4), pilocytic astrocytoma (n = 3), grade 2 astrocytoma (n = 1), dysembryoplastic neuroepithelial tumor (n = 1), meningioangiomatosis (n = 1), choroid plexus carcinoma (n = 1), embryonal tumor with multilayered rosettes (n = 1), and 3 unclassified brain tumors. Seven patients (47%) had underlying syndromes: tuberous sclerosis (n = 5), neurofibromatosis type 1 (n = 1), and Sturge-Weber syndrome (n = 1). Prior therapies ranged from none to eight (median 0). Two patients progressed within 2 months post-LITT. Thirteen of 15 patients (87%) achieved durable local control without progression or additional therapy, with a minimum follow-up of 36 months. No patients required repeat LITT, experienced permanent neurologic deficits, or treatment-related mortality.
Conclusions
In this single-institution pediatric cohort, LITT was associated with high rates of durable local tumor control and low treatment-related morbidity across diverse tumor types. These findings support LITT as a complementary local control strategy within multidisciplinary pediatric neuro-oncology care and underscore the need for multi-institutional studies incorporating molecular classification and long-term oncologic outcomes.