Fluorescence-guided resections and photodynamic therapy for malignant gliomas using 5-aminolevulinic acid

Herbert G. Stepp; Tobias Beck; Wolfgang Beyer; Thomas Pongratz; Ronald Sroka; Reinhold Baumgartner; Walter Stummer; Bernhard Olzowy; Jan Hinnerk Mehrkens; Joerg Christian Tonn; Hans Juergen Reulen

doi:10.1117/12.591526

25 April 2005 Fluorescence-guided resections and photodynamic therapy for malignant gliomas using 5-aminolevulinic acid

Herbert G. Stepp, Tobias Beck, Wolfgang Beyer, Thomas Pongratz, Ronald Sroka, Reinhold Baumgartner, Walter Stummer, Bernhard Olzowy, Jan Hinnerk Mehrkens, Joerg Christian Tonn, Hans Juergen Reulen

Author Affiliations +

Proceedings Volume 5686, Photonic Therapeutics and Diagnostics; (2005) https://doi.org/10.1117/12.591526
Event: SPIE BiOS, 2005, San Jose, CA, United States

Abstract

Oral application of 20 mg/kg bw of 5-aminolevulinic acid results in a highly specific accumulation of fluorescent and phototoxic Protoporphyrin IX in malignant glioma tissue. Surgical removal with fluorescence guidance is studied in a phase III clinical trial, adjuvant Photodynamic Therapy (PDT) to the surgical cavity is in phase II and for interstitial PDT of recurrent gliomas, a phase I/II study has started. Fluorescence guided resections have been shown to be safe and effective in augmenting neurosurgical removal of malignant gliomas in 52 consecutive patients. Intra-operative fluorescence spectroscopy showed statistically significant higher sensitizer accumulation in vital brain tumor versus the infiltration zone and in the infiltration zone versus adjacent normal brain, which contained very little PPIX. This is promisingly exploited for PDT - both to the surgical cavity by surface irradiation and for stereotactically guided interstitial irradiation.

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Herbert G. Stepp, Tobias Beck, Wolfgang Beyer, Thomas Pongratz, Ronald Sroka, Reinhold Baumgartner, Walter Stummer, Bernhard Olzowy, Jan Hinnerk Mehrkens, Joerg Christian Tonn, and Hans Juergen Reulen "Fluorescence-guided resections and photodynamic therapy for malignant gliomas using 5-aminolevulinic acid", Proc. SPIE 5686, Photonic Therapeutics and Diagnostics, (25 April 2005); https://doi.org/10.1117/12.591526

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