Abstract
Surgery is essential in the treatment of high-grade gliomas (HGG) and gross total resection (GTR) is known to increase the overall survival and progression-free survival. Several studies have shown that fluorescence-guided surgery with 5-aminolevulinic acid (5-ALA) increases GTR considerably compared to white light surgery (65% vs. 36%). In recent years, sodium fluorescein (SF) has become an increasingly popular agent for fluorescence-guided surgery due to numerous utility benefits compared to 5-ALA, including lower cost, non-toxicity, easy administration during surgery and a wide indication range covering all contrast-enhancing lesions with disruption of the blood–brain barrier in the CNS. However, currently, SF is an off-label agent and the level of evidence for use in HGG surgery is inferior compared to 5-ALA. Here, we give an update and review the latest literature on fluorescence-guided surgery with 5-ALA and SF for brain tumors with emphasis on fluorescence-guided surgery in HGG and brain metastases. Further, we assess the advantages and disadvantages of both fluorophores and discuss their future perspectives.
| Original language | English |
|---|---|
| Article number | 617 |
| Journal | Cancers |
| Volume | 14 |
| Issue number | 3 |
| Number of pages | 16 |
| ISSN | 2072-6694 |
| DOIs | |
| Publication status | Published - 1. Feb 2022 |
Bibliographical note
Publisher Copyright:© 2022 by the authors. Licensee MDPI, Basel, Switzerland.
Keywords
- 5-ALA
- Brain metastases
- Fluorescence-guided surgery
- Glioblastoma
- Glioma
- Resection
- Sodium fluorescein