Department of Neurosurgery, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Yuexiu District, Guangzhou, 510060, People's Republic of China.
State Key Laboratory of Oncology in South China, Guangzhou, 510060, People's Republic of China.
J Neurooncol. 2022 Jul;158(3):463-470. doi: 10.1007/s11060-022-04035-2. Epub 2022 Jun 3.
Surgical resection of medulloblastoma (MB) remains a challenge. At present, a variety of tracers have been used for intraoperative tumor visualization. However, there are few reports on the intraoperative visualization of MB. Hence, we reported our experience of applying fluorescein sodium (FS) in MB surgery.
We retrospectively analyzed the clinical information of patients with MB confirmed by surgery and pathology from January 2016 to December 2020 from Sun Yat-sen University Cancer Center. A total of 62 patients were enrolled, of which 27 received intraoperative FS and 35 did not. The intraoperative dose of FS was 3 mg/kg.
Among the 62 patients, 42 were males, and twenty were females. The age of onset in the FS group was 9.588 ± 7.322, which in the non-fluorescein sodium group was 13.469 ± 10.968, p = 0.198. We did not find significant differences in tumor location, tumor size, tumor resection, tumor histology, and preoperative symptoms (hydrocephalus, headache, vomit, balance disorder) between the groups. There was no significant difference in the postoperative symptoms (hydrocephalus, headache, vomiting, balance disorder, and cerebellar mutism). However, patients in the FS group had a relatively low incidence of balance disorder and cerebellar mutism. There was definite fluorescence of tumor in all cases of the FS group, and even the tiny metastatic lesion was visible. No case had side effects related to the use of FS.
FS is safe and effective in MB surgery. Whether the application of FS for surgery can reduce complications remains to be studied in the future.
髓母细胞瘤(MB)的手术切除仍然是一个挑战。目前,已经有多种示踪剂用于术中肿瘤可视化。然而,关于 MB 的术中可视化的报道很少。因此,我们报告了我们在 MB 手术中应用荧光素钠(FS)的经验。
我们回顾性分析了中山大学肿瘤防治中心 2016 年 1 月至 2020 年 12 月期间经手术和病理证实的 MB 患者的临床资料。共纳入 62 例患者,其中 27 例行术中 FS,35 例未行 FS。术中 FS 剂量为 3mg/kg。
在 62 例患者中,男性 42 例,女性 20 例。FS 组发病年龄为 9.588±7.322,非 FS 组为 13.469±10.968,p=0.198。两组患者肿瘤位置、肿瘤大小、肿瘤切除程度、肿瘤组织学及术前症状(脑积水、头痛、呕吐、平衡障碍)差异均无统计学意义。术后症状(脑积水、头痛、呕吐、平衡障碍、小脑缄默症)也无统计学差异。但 FS 组患者平衡障碍和小脑缄默症的发生率相对较低。FS 组所有病例均有明确的肿瘤荧光,甚至微小的转移病灶也可见。无与 FS 使用相关的不良反应。
FS 在 MB 手术中安全有效。FS 在手术中的应用是否能降低并发症的发生率,还有待进一步研究。