Abstract:
The blood-brain barrier (BBB) is a selectively semi-permeable layer, crucial in shielding the brain from external pathogens and toxic substances while maintaining ionic homeostasis and sufficient nutrient supply. However, it poses a significant challenge for drugs to penetrate the BBB in order to effectively target brain tumors. Magnetic resonance-guided laser interstitial thermal therapy (MRg-LITT) is a minimally invasive technique that employs thermal energy to cauterize intracranial lesions with the potential to temporarily disrupt the BBB. This further opens a possible therapeutic window to enhance patient outcomes. Here, we review the impact of MRg-LITT on BBB and blood tumor barrier (BTB) and the duration of the BBB disruption. Studies have shown that MRg-LITT is effective due to its minimally invasive nature, precise tumor targeting, and low complication rates. Although the disruption duration varies across studies, the average peak disruption is within the initial two weeks post-ablation period and subsequently exhibits a gradual decline. However, further research involving larger groups with extended follow-up periods is required to determine disruption duration more accurately. In addition, evaluating toxicity and glymphatic system disruption is crucial to circumvent potential risks associated with this procedure.
摘要:
血脑屏障(BBB)是一个选择性的半渗透层,至关重要的是保护大脑免受外部病原体和有毒物质的侵害,同时保持离子稳态和充足的营养供应。然而,这对药物穿透BBB以有效靶向脑肿瘤提出了重大挑战。磁共振引导激光间质热疗法(MRg-LITT)是一种微创技术,可利用热能烧灼颅内病变,有可能暂时破坏BBB。这进一步打开了可能的治疗窗口以增强患者结果。这里,我们回顾了MRg-LITT对BBB和血肿瘤屏障(BTB)的影响以及BBB破坏的持续时间。研究表明,MRg-LITT由于其微创性质而有效,精确的肿瘤靶向,并发症发生率低。尽管中断持续时间因研究而异,平均中断高峰在消融后的最初两周内,随后呈现逐渐下降.然而,需要对随访时间延长的较大群体进行进一步研究,以更准确地确定中断持续时间.此外,评估毒性和淋巴系统的破坏对于规避与该程序相关的潜在风险至关重要.