Laser Interstitial Thermal Therapy for radiation adverse Inf
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Brain metastases are the most common type of intracranial tumor, and confer a dismal prognosis. Morbidity in these patients arises not only from tumor burden
but from treatment-related toxicities. Among the most significant of these is radiation necrosis, a common sequelae of stereotactic radiosurgery that may cause neurologic impairment through mass effect or steroid-refractory edema. Truly, “radiation necrosis” is a misnomer, as the process is more accurately an adverse inflammatory response post-stereotactic radiotherapy (AIRS). Because it is impossible to reliably distinguish AIRS from tumor recurrence without a biopsy, and because high-dose steroids are poorly tolerated, management of AIRS poses a significant therapeutic challenge. Laser interstitial thermal therapy (LITT) is an emerging minimally-invasive treatment modality which uses
hyperthermia to ablate intracranial pathologic tissues. Here, we describe the use of LITT in a patient with steroid-refractory AIRS following radiosurgery for a right supplementary motor area metastatic focus and provide a brief review of the utility of LITT in patients with AIRS.

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