NSRG-23. 5-Aminolevulinic acid guided resection of paediatric central nervous system tumours: the largest single centre series in the UK
Published in: Neuro-Oncology
Authors: Charlotte Burford; Nida Kalyal; Anand Pandit; Jose Pedro Lavrador; Cristina Bleil; Ahilan Kailaya-Vasan; Bassel Zebian
Year: 2018
Publication details: 20(Suppl 2):i150
DOI: 10.1093/neuonc/noy059.545
Publication type: Conference abstract / case series
Topic: paediatric brain tumour, 5-ALA, fluorescence-guided surgery, CNS tumours, surgical adjunct
Simple summary
This work reflects interest in technologies that may help surgeons distinguish tumour tissue during complex operations. It should be presented cautiously, noting that paediatric evidence is still developing and usefulness varies by tumour type.
Mr Kailaya-Vasan’s involvement
Mr Kailaya-Vasan, consultant neurosurgeon and neurovascular surgeon, is listed as a contributing author on this publication.
Published abstract
The following abstract is reproduced from the original publication and is provided for reference. It may include technical terminology intended for clinical or academic audiences.
5-aminolevulinic acid (5-ALA, Gliolan) is widely used in adults for facilitating the resection of high-grade gliomas. However, its safety and efficacy in the paediatric population remains to be established. We present the UK’s first case series of 10 patients, undergoing 11 operations with 5-ALA. METHODS 10 consecutive patients (aged 1.6-15 years) underwent pre-operative administration of 20mg/kg of 5-ALA. The tumours were visualised intra-operatively under violet-blue light and the presence and usefulness of fluorescence was assessed. RESULTS Strong fluorescence was observed in two WHO grade III ependymomas and a GBM (IV). Moderate fluorescence was seen in one pilocytic astrocytoma (I) and a pilomxyoid astrocytoma (II). Weak fluorescence was observed in a diffuse astrocytoma (II). The tumours types which showed no fluorescence included: a pilocytic astrocytoma, a glioneuronal tumour (II) and an anaplastic medulloblastoma (IV). No significant adverse drug reactions were recorded in any of the patients. CONCLUSIONS Our case series adds to the evidence base supporting the safety of 5-ALA in the paediatric population. However, the diverse range of responses to 5-ALA in these tumours highlights the need for further trials into its usefulness in specific tumour types.
Disclaimer
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