Lighting Up Brain Tumors Improved Survival in Short Term

Study found technique helped surgeons remove more of the malignant mass

THURSDAY, April 27, 2006 (HealthDay News) -- Lighting up brain tumors so their edges can be more clearly seen resulted in more thorough removal of tumors and a significant delay in cancer recurrence for patients.

According to the authors of a German study in the May issue of Lancet Oncology, the technique is "simple, cheap and can be performed in real-time."

But widespread use of the technique may still be a ways off, cautioned another expert.

"The novel thing is they're taking a very different approach to operating on brain tumors. They get high points for innovation and novelty. It's simple, it's elegant," said Dr. Paul Graham Fisher, the Beirne Family Director of Neuro-Oncology at Stanford University. "The negative side is it may be a little preliminary."

"It's a great first punch, but a lot more is needed," he added.

The patients suffered from brain tumors known as malignant gliomas, which have a notoriously poor prognosis.

"In almost every solid tumor in oncology, the fundamental is trying to remove as much of the tumor as possible," Fisher explained. "The problem with gliomas is that they are finger-like and diffuse. It's very hard to tell where things begin and where they end."

Removing more of the tumor would obviously result in better survival. The challenge is being able to do that precisely.

This study, from investigators at Heinrich-Heine University in Dusseldorf, looked at 5-aminolevulinic acid (ALA), an amino acid that causes fluorescent compounds to gather in malignant tissue. The German pharmaceutical company Medac funded the study.

The researchers compared two groups of patients with malignant gliomas (a total of 322 patients). One group was operated on with fluorescence-guided surgery, while the other underwent surgery under conventional white light. Patients were followed for a median of almost three years.

Significantly more patients who received fluorescence-guided surgery had their tumors completely removed than those who underwent usual surgery (65 percent vs. 36 percent).

Also, more participants in the fluorescence group survived to six months without any progression of their tumor (41 percent vs. 21 percent).

There was no difference in serious side effects between the two groups. Nor, unfortunately, was there any difference in overall survival.

"The dye group did significantly better [at first] but, if you look at the curves as time goes on, it's not quite as durable," Fisher said.

"I don't think people are going to jump to making this the standard of care," Fisher said. "It's going to warrant further study."

More information

To learn more about brain tumors, visit the National Library of Medicine.

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