Interventional magnetic-resonance-guided cryotherapy combined with microsurgery for recurrent glioblastoma: An innovative treatment?

Glioblastoma invariably recurs after primary Stupp tumor therapy and portends a poor prognosis. Cryoablation is a well-established treatment strategy for extra-cranial tumors. The safety and efficacy of interventional MR-guided cryoablation (iMRgC) has not been explored in recurrent glioblastoma. A retrospective analysis of data collected over a period of 24 months was performed. The inclusion criteria were: (I) recurrent glioblastoma despite Stupp protocol; (II) MRI followed by histological confirmation of recurrent glioblastoma; (III) location allowing iMRgC followed by microsurgical resection; and (IV) patient's consent. The primary objective was to assess feasibility in terms of complications. The secondary objective was to analyze progression-free survival (PFS), post-iMRgC survival and overall survival (OS). The study included 6 patients, with a mean age of 67±7.6 years [range, 54–70 years]. No major complications were observed. Median PFS was 7.5 months [IQR 3.75–9.75] and 6-month PFS was 50%. Median post-iMRgC survival was 9 months [IQR 7.5–15.25] and 6-month post-iMRgC survival was 80%. Median OS was 22.5 months [IQR 21.75–30]. iMRgC for recurrent glioblastoma demonstrated a good safety profile, with no major complications. Our data suggest improved PFS and OS. No. IRB00011687 retrospectively registred on July 7th 2021.