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Fluorescent Drug Allows Better Glioma Resection and Survival

Sixty-five percent of patients have complete resection, compared with 36 percent of others

FRIDAY, April 28 (HealthDay News) -- Patients with malignant gliomas have a more successful resection and higher progression-free survival rate if they are given 5-aminolevulinic acid, which makes their tumors fluoresce during surgery, according to a report in the May issue of The Lancet Oncology.

Walter Stummer, M.D., from Heinrich-Heine University in Dusseldorf, Germany, and colleagues studied 270 patients with suspected malignant glioma. Of these, 139 were randomly assigned to receive 5-aminolevulinic acid for fluorescence-guided resection while 131 received conventional microsurgery with white light. A non-fluorescent prodrug, 5-aminolevulinic acid causes the accumulation of fluorescent porphyrins in gliomas. The median follow-up was 35.4 months.

Sixty-five percent of patients with fluorescent tumors had a complete resection compared with 36 percent of controls. The six-month progression-free survival was also 19.9 percent higher in patients receiving 5-aminolevulinic acid compared with those not treated with the drug (41 versus 21.1 percent). The frequency of adverse events was similar in the two groups, according to the study.

"Tumor fluorescence derived from 5-aminolevulinic acid enables more complete resections of contrast-enhancing tumor, leading to improved progression-free survival in patients with malignant glioma," Stummer and colleagues conclude.

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