直接激光热疗法（LITT）可以作为治疗难以到达的新诊断的多形性恶性胶质瘤（ndGBM）的一部分。然而，其消融范围并不常规定量；因此，其对患者肿瘤学结局的具体影响尚不清楚。为了系统地测量ndGBM患者队列中的消融范围及其对患者无进展生存期（PFS）和总体生存期（OS）以及其他治疗相关参数的影响，进行了回顾性研究。在2011年至2021年期间，对56名等异构柠檬酸脱氢酶1/2野生型的ndGBM患者进行了直接LITT治疗。分析了患者的基本情况、肿瘤学过程和LITT相关参数。患者的中位年龄为62.3岁（31-84岁），中位随访时间为11.4个月。正如预期的那样，接受全化学放疗的患者亚组的PFS和OS最好（n = 34）。进一步的分析表明，其中10例接受了近乎完全的消融，并且PFS（10.3个月）和OS（22.7个月）明显改善。值得注意的是，检测到84％的过多消融，但这与更高的神经功能障碍发生率无关。肿瘤体积也被发现影响PFS和OS，但由于样本数量较少，不可能进一步证实这一发现。本研究展示了最大规模的ndGBM患者进行直接LITT治疗的数据分析。近乎完全的消融显示出对患者的PFS和OS具有显著益处。重要的是，即使在过多消融的情况下，它也被证明是安全的，因此在使用这种模式治疗ndGBM时可以考虑使用它。版权所有©2023年神经外科医生大会。保留所有权利。

Upfront laser interstitial thermal therapy (LITT) can be used as part of the treatment paradigm in difficult-to-access newly diagnosed glioblastoma multiforme (ndGBM) cases. The extent of ablation, though, is not routinely quantified; thus, its specific effect on patients' oncological outcomes is unclear.To methodically measure the extent of ablation in the cohort of patients with ndGBM and its effect, and other treatment-related parameters, on patients' progression-free survival (PFS) and overall survival (OS).A retrospective study was conducted on 56 isocitrate dehydrogenase 1/2 wild-type patients with ndGBM treated with upfront LITT between 2011 and 2021. Patient data including demographics, oncological course, and LITT-associated parameters were analyzed.Patient median age was 62.3 years (31-84), and the median follow-up duration was 11.4 months. As expected, the subgroup of patients receiving full chemoradiation was found to have the most beneficial PFS and OS (n = 34). Further analysis showed that 10 of them underwent near-total ablation and had a significantly improved PFS (10.3 months) and OS (22.7 months). Notably, 84% excess ablation was detected which was not related to a higher rate of neurological deficits. Tumor volume was also found to influence PFS and OS, but it was not possible to further corroborate this finding because of low numbers.This study presents data analysis of the largest series of ndGBM treated with upfront LITT. Near-total ablation was shown to significantly benefit patients' PFS and OS. Importantly, it was shown to be safe, even in cases of excess ablation and therefore could be considered when using this modality to treat ndGBM.Copyright © Congress of Neurological Surgeons 2023. All rights reserved.