What role does laser interstitial thermal therapy (LITT) play in the treatment of primary and metastatic brain neoplasms?

LITT is more commonly used for metastatic brain neoplasms at our institution in certain scenarios. It is used for patients with radionecrosis after Gamma Knife/SRS if patients do not respond to steroids or bevacizumab. It is also used for patients with tumor recurrence after SRS in locations that are challenging to resect. LITT for primary gliomas is less common and primarily considered in the recurrent setting, although there are few exceptions to this as well.