Aminolevulinic acid (ALA)-protoporphyrin IX fluorescence guided tumour resection. Part 1: Clinical, radiological and pathological studies

Colditz, Michael J. and Jeffree, Rosalind L. (2012) Aminolevulinic acid (ALA)-protoporphyrin IX fluorescence guided tumour resection. Part 1: Clinical, radiological and pathological studies. Journal of Clinical Neuroscience, 19 11: 1471-1474. doi:10.1016/j.jocn.2012.03.009


Author Colditz, Michael J.
Jeffree, Rosalind L.
Title Aminolevulinic acid (ALA)-protoporphyrin IX fluorescence guided tumour resection. Part 1: Clinical, radiological and pathological studies
Journal name Journal of Clinical Neuroscience   Check publisher's open access policy
ISSN 0967-5868
Publication date 2012-01-01
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1016/j.jocn.2012.03.009
Open Access Status Not Open Access
Volume 19
Issue 11
Start page 1471
End page 1474
Total pages 4
Place of publication London, United Kingdom
Publisher Churchill Livingstone
Language eng
Abstract The intraoperative identification and resection of glioma is a significant and important challenge in neurosurgery. Complete resection of the enhancing tumour increases the median survival time in glioblastoma compared to partial glioma resection; however, it is achieved in fewer than half of eligible patients when conventional tumour identification methods are used. Increasing the incidence of complete resection, without causing excess morbidity, requires new methods to accurately identify neoplastic tissue intraoperatively, such as use of the drug 5-amino-levulinic acid (ALA). After ALA ingestion, the fluorescent molecule protoporphyrin IX (PpIX) accumulates in high grade glioma, allowing the neurosurgeon to more easily detect and accurately resect tumour. The utility of ALA has been demonstrated in a large, multicentre phase III randomised control trial of 243 patients with high grade glioma. ALA use led to a significant increase in the incidence of complete resection (65% compared to 36%), improved progression-free survival at 6 months (41% compared to 21%), fewer reinterventions, and delayed onset of neurological deterioration. This review provides a broad assessment of ALA-PpIX fluorescence-guided resection, with Part 1 focusing on its clinical efficacy, and correlations with imaging and histology. The theoretical, biochemical and practical aspects of ALA use are reviewed in Part 2.
Keyword ALA
Aminolevulinic acid
Fluorescence guided resection
Gliolan
Glioma
Protoporphyrin IX
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collection: School of Medicine Publications
 
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