5‐ALA in the management of malignant glioma
Open accessAbstract
Background: Patients suffering from malignant gliomas have a poor prognosis. For the surgical treatment of these tumors, 5‐aminolevulinic acid (5‐ALA) has become a new standard. Aims: This review intends to provide an overview over current status, significance, limitations, and future perspectives of 5‐ALA based fluorescence guided surgery and photodynamic therapy for brain tumor patients. Materials and Methods: From peer reviewed publications on the many aspects connected with this topic, those with potential clinical relevance were selected and put in the context of our own experience. Results and Discussion: The high tumor selectivity of accumulation of fluorescent protoporphyrin IX (PpIX) after systemic administration of 5‐ALA enables intra‐operative fluorescence guidance, which is unimpaired by brainshift and does not require expensive equipment. The neurosurgical aim of complete resection of enhancing tumor can now more easily be achieved, which improves prognosis in these patients. Nevertheless, despite better surgery tumors will inevitably recur. In order to further prolong survival, the phototoxic properties of PpIX are presently being exploited in clinical trials of post‐operative or interstitial photodynamic therapy (PDT). Conclusion: 5‐ALA based fluorescence guidance and PDT offer an intriguing new option for the management of malignant gliomas. Lasers Surg. Med. 50:399–419, 2018. © 2018 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals LLC
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Heme possesses neither fluorescence nor photosensitizing activity due to insertion of paramagnetic iron into PpIX.
“With the insertion of paramagnetic iron into PpIX, heme possesses neither fluorescence nor photosensitizing activity [9].”
From 5-Aminolevulinic Acid as a Theranostic Agent for Tumor Fluorescence Imaging and Photodynamic Therapy (2023) · cites this paper as [9]
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Photodynamic therapy in neurooncology
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- Authors
- Stepp, H., & Stummer, W.
- Affiliations
- LMU Klinikum (DE)
- University Hospital Münster (DE)
- Corresponding author
- Stepp, Herbert
- Venue
- Lasers in Surgery and Medicine
- Publisher
- Wiley
- Published
- 2018-05-08
- Volume
- 50
- Issue
- 5
- Pages
- 399-419
- ISSN
- 0196-8092 (ISSN-L)
- 1096-9101
- OpenAlex
- W2800708604
- Cited by
- 234
- References
- 239
- Citations by year
- 2026: 14 · 2025: 30 · 2024: 35 · 2023: 30 · 2022: 34 · 2021: 31 · 2020: 34 · 2019: 22 · 2018: 4
- FWCI
- 4.06
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Lasers in Surgery and Medicine (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Photodynamic Therapy Research Studies
- Health Sciences › Medicine › Genetics › Glioma Diagnosis and Treatment
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Optical Imaging and Spectroscopy Techniques
- Keywords
- 5-aminolevulinic acid, high-grade glioma, fluorescence-guided surgery, photodynamic therapy, protoporphyrin IX, brain tumor resection, recurrent glioma, interstitial photodynamic therapy, brain shift
- MeSH terms
- Aminolevulinic Acid, Brain Neoplasms, Glioma, Humans, Photochemotherapy, Photosensitizing Agents
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