AI Article Synopsis
- The study aimed to evaluate the safety and effectiveness of using 5-aminolevulinic acid (5-ALA) for intraoperative fluorescence diagnosis during surgeries for recurrent neuroepithelial tumors in children.
- Data was collected from 13 children aged 3 to 17, with 5-ALA administered before surgery, and the results showed varying degrees of fluorescence in tumor tissues, leading to successful tumor resections in most cases.
- Overall, the fluorescence diagnosis technique was found to be safe, enhancing the detection and differentiation of tumors while highlighting the need for further research on its effectiveness across different ages and types of tumors.
Article Abstract
Aim: To analyze the efficacy and safety of 5-aminolevulinic acid for intraoperative fluorescence diagnosis (FD) during repeated surgery for recurrent neuroepithelial tumors (NETs) in children.
Material And Methods: We performed a retrospective analysis of the results of recurrent NET resection in 13 children aged from 3 to 17 years in the period between December 2013 and May 2015. The source of 5-ALA was a drug "Alasens" that was administered at a dose of 20 mg/kg of body weight 4 h before the beginning of tumor resection. A visual scale was used to evaluate the fluorescence intensity. The drug was used with the informed consent of the child's parents and approval of the Polenov Neurosurgical Institute ethics committee. All patients underwent complex clinical and introscopic examination in the pre- and postoperative periods and a repeated histological tumor examination.
Results: There was no fluorescence in 4 cases (Gr I in 2 cases; Gr II in 2 cases). Grade 1 fluorescence (Gr II) was observed in one case, and grade 2-3 fluorescence was observed in the remaining 8 patients. Total and subtotal tumor resection was achieved in 11 (84.6%) of 13 patients. There were no clinically significant adverse effects. A transient increase in transaminases was observed in 2 patients. Two girls had an elevated photosensitivity to light for two days.
Conclusion: FD is a safe technique in childhood and can improve intraoperative detection of NET during its repeated growth as well as differentiate the tumor from pathological tissues of non-tumorous nature, which increases completeness of blastomatous tissue removal. However, the character and intensity of fluorescence may change in recurrent NETs. Further research is required to investigate the FD effectiveness in various age patients with tumors of a different histological structure and malignancy in the case of both primary and recurrent lesions.
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| http://dx.doi.org/10.17116/neiro201780751-57 | DOI Listing |
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