French surgeons destroy brain tumour on conscious patient in world first

By Henry Samuel in Paris
Last Updated: 11:40PM BST 29 Aug 2008

http://www.telegraph.co.uk/news/worldne … first.html

The team from Pitié-Salpêtrière hospital in Paris drilled a 3mm hole into the skull of a patient under local anaesthetic, inserting a tiny fibre-optic cable armed with a laser.

The doctors were then able to "see" the metastatic tumour and steer the cable thanks to a MRI (magnetic resonance imaging) scan, which uses magnetic and radio waves.

Once inside the skull, they carried out a computer simulation of the treatment. Then they activated the laser, which heated and killed the tumour tissue for up to two minutes. The MRI scan allowed them to modify the exact energy output needed from the laser.

The patient remained wide awake throughout and was said to have felt nothing. Once all the cancer cells were dead, the cable was removed and the patient allowed to return home the same day.

"This is the first time that laser technology has been used inside the skull and that it is associated with a MRI giving real time data", chief surgeon Alexandre Carpentier told Le Monde newspaper.

The results have been published in a paper in the Neurosurgeryjournal.

The ground-breaking surgical trials were conducted on 15 patients over the past two years, overseen by France's health security agency Afssaps. None of the patients' tumours responded to conventional treatment and their life expectancy if untreated was no more than three months.

Only six of the operations were total - covering the whole tumour. Of those, five out of six had no remissions in the nine months following surgery.

Later operations involved patients with several or larger tumours.

The surgery was made possible thanks to a revolutionary American-designed laser that is permanently chilled to avoid causing blood clots on contact with the brain or epileptic fits.

The team believes that their successes could pave the way for a whole new type of "interventional" MRI treatment.

However, it said it lacked the necessary funds to take its research further, and needed a further two million euros to progress.

Secondary brain cancer or cerebral metastasis is the most common malignancy affecting the brain, and is present in a fifth of all people who die of cancer. It is formed when cells from a primary cancer, usually in the lungs, are pumped around the body in the blood and clump together in the brain.

The French results will now undergo months, probably years, of further stringent tests.

link do badan klinicznych:

http://clinicaltrials.gov/ct2/show/NCT00392119