With a Little Help from My Friends: The Role of Intraoperative Fluorescent Dyes in the Surgical Management of High-Grade Gliomas
| Autor: | Mariangela Pino, Carlo Gulì, Gabriele Costantino, Francesca Graziano, Domenico Gerardo Iacopino, Giuseppe Roberto Giammalva, Alessandro E. P. Villa, Natale Francaviglia, Rosario Maugeri, Alessia Imperato, Francesco Meli |
|---|---|
| Přispěvatelé: | Maugeri R., Villa A., Pino M., Imperato A., Giammalva G.R., Costantino G., Graziano F., Guli C., Meli F., Francaviglia N., Iacopino D |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Oncology
medicine.medical_specialty Review lcsh:RC321-571 Resection 03 medical and health sciences chemistry.chemical_compound High-grade glioma 0302 clinical medicine Glioma Internal medicine YELLOW 560 filter Medicine fluorescein sodium astrocytoma lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry Protoporphyrin IX Settore MED/27 - Neurochirurgia business.industry General Neuroscience glioblastoma Astrocytoma Multimodal therapy medicine.disease Fluorescence extent of resection chemistry 5-aminolevulinic acid 030220 oncology & carcinogenesis Primary Malignant Brain Tumors Sodium fluorescein business high-grade gliomas 030217 neurology & neurosurgery |
| Zdroj: | Brain Sciences Brain Sciences, Vol 8, Iss 2, p 31 (2018) |
| ISSN: | 2076-3425 |
| Popis: | High-grade gliomas (HGGs) are the most frequent primary malignant brain tumors in adults, which lead to death within two years of diagnosis. Maximal safe resection of malignant gliomas as the first step of multimodal therapy is an accepted goal in malignant glioma surgery. Gross total resection has an important role in improving overall survival (OS) and progression-free survival (PFS), but identification of tumor borders is particularly difficult in HGGS. For this reason, imaging adjuncts, such as 5-aminolevulinic acid (5-ALA) or fluorescein sodium (FS) have been proposed as superior strategies for better defining the limits of surgical resection for HGG. 5-aminolevulinic acid (5-ALA) is implicated as precursor in the synthetic pathway of heme group. Protoporphyrin IX (PpIX) is an intermediate compound of heme metabolism, which produces fluorescence when excited by appropriate light wavelength. Malignant glioma cells have the capacity to selectively synthesize or accumulate 5-ALA-derived porphyrins after exogenous administration of 5-ALA. Fluorescein sodium (FS), on the other hand, is a fluorescent substance that is not specific to tumor cells but actually it is a marker for compromised blood-brain barrier (BBB) areas. Its effectiveness is confirmed by multicenter phase-II trial (FLUOGLIO) but lack of randomized phase III trial data. We conducted an analytic review of the literature with the objective of identifying the usefulness of 5-ALA and FS in HGG surgery in adult patients. |
| Databáze: | OpenAIRE |
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