Halani Sameer H, Adamson D Cory
Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA, USA.
Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA, USA; Neurosurgery Section, Atlanta VA Medical Center, Decatur, GA, USA.
Onco Targets Ther. 2016 Sep 12;9:5629-42. doi: 10.2147/OTT.S97030. eCollection 2016.
Surgical resection is typically the first line of treatment for gliomas. However, the neurosurgeon faces a major challenge in achieving maximal resection in high-grade gliomas as these infiltrative tumors make it difficult to discern tumor margins from normal brain with conventional white-light microscopy alone. To aid in resection of these infiltrative tumors, fluorescence-guided surgery has gained much popularity in intraoperative visualization of malignant gliomas, with 5-aminolevulinic acid (5-ALA) leading the way. First introduced in an article in Neurosurgery, 5-ALA has since become a safe, effective, and inexpensive method to visualize and improve resection of gliomas. This has undoubtedly led to improvements in the clinical course of patients as demonstrated by the increased overall and progression-free survival in patients with such devastating disease. This literature review aims to discuss the major studies and trials demonstrating the clinical utility of 5-ALA and its ability to aid in complete resection of malignant gliomas.
手术切除通常是胶质瘤的一线治疗方法。然而，神经外科医生在实现高级别胶质瘤的最大程度切除上面临重大挑战，因为这些浸润性肿瘤仅通过传统白光显微镜很难区分肿瘤边界与正常脑组织。为了辅助切除这些浸润性肿瘤，荧光引导手术在恶性胶质瘤的术中可视化方面已广受欢迎，其中5-氨基乙酰丙酸（5-ALA）处于领先地位。5-ALA首次在一篇神经外科文章中被引入，此后已成为一种安全、有效且廉价的可视化和改善胶质瘤切除的方法。正如患有这种毁灭性疾病的患者总体生存率和无进展生存率的提高所证明的那样，这无疑改善了患者的临床病程。这篇文献综述旨在讨论主要的研究和试验，这些研究和试验证明了5-ALA的临床效用及其辅助完全切除恶性胶质瘤的能力。
