The role of simultaneous stereotactic biopsy and radiofrequency ablation in the management of brain neoplasms in countries with limited financial resources

Abstract Background Heat can help control the progression of intra-axial cerebral neoplasms in selected cases. RF (Radiofrequency) is available and cost effective in resource-limited settings. RF stereotactic heat was delivered simultaneously with the biopsy in brain tumors. Objective We evaluated the safety and feasibility of stereotactic RF ablation of intra-axial brain neoplasms during stereotactic brain biopsy procedure. Methods Twenty-two adult patients were treated with interstitial hyperthermia by RF plus stereotactic brain tumor biopsy in Ain shams University Hospitals from 2022 to 2024. Follow-up for tumor progression was done over a period of 12 months. Results A total of 22 participants have been enrolled; follow-up period was 12 months. There were 12 (54.5%) females and 10 (45.5%) males. The mean and median ages were 53.6 years (range 25–72) and 54 years, respectively. 72.6% had at least a single baseline comorbidity. From the ablated tumors, 17 were primary, 4 were metastatic, and 1 was in-field necrosis. Median tumor volume was 6 cm 3 and mean was 10.2 cm 3 (range, 0.5–40 cm 3 ). The one-year estimated survival rate was 86.6%, and this was impacted by disease etiology. Conclusions Results from this study demonstrate that RF ablation is a safe technique that it can be used simultaneously with stereotactic biopsy in selected cases of intra-axial brain neoplasms. A potential trend of longer progression-free interval of tumor is presumed in the cases. In resource-limited settings, RF ablation can be a safe and available alternative to LITT (Laser Interstitial Thermocoagulative Therapy) that can deliver heat to intracranial tumors.