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首页> 外文期刊>Neurosurgical focus >Is fluorescein-guided technique able to help in resection of high-grade gliomas?
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Is fluorescein-guided technique able to help in resection of high-grade gliomas?

机译：荧光素引导技术是否可以帮助切除高级神经胶质瘤？

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Object: Fluorescein, a dye that is widely used as a fluorescent tracer, accumulates in cerebral areas where the blood-brain barrier is damaged. This quality makes it an ideal dye for the intraoperative visualization of high-grade gliomas (HGGs). The authors report their experience with a new fluorescein-guided technique for the resection of HGGs using a dedicated filter on the surgical microscope. Methods: The authors initiated a prospective Phase II trial (FLUOGLIO) in September 2011 with the objective of evaluating the safety of fluorescein-guided surgery for HGGs and obtaining preliminary evidence regarding its efficacy for this purpose. To be eligible for participation in the study, a patient had to have suspected HGG amenable to complete resection of the contrast-enhancing area. The present report is based on the analysis of the short- and long-term results in 20 consecutive patients with HGGs (age range 45-74 years), enrolled in the study since September 2011. In all cases fluorescein (5-10 mg/kg) was injected intravenously after intubation. Tumor resection was performed with microsurgical technique and fluorescence visualization by means of BLUE 400 or YELLOW 560 filters on a Pentero microscope. Results: The median preoperative tumor volume was 30.3 cm3 (range 2.4-87.8 cm3). There were no adverse reactions related to fluorescein administration. Complete removal of contrast-enhanced tumor was achieved in 80% of the patients. The median duration of follow-up was 10 months. The 6-months progression-free survival rate was 71.4% and the median survival was 11 months. Conclusions: Analysis of these 20 cases suggested that fluorescein-guided technique with a dedicated filter on the surgical microscope is safe and allows a high rate of complete resection of contrast-enhanced tumor as determined on early postoperative MRI. Clinical trial registration no.: 2011-002527-18 (EudraCT).
机译：目的：荧光素，一种广泛用作荧光示踪剂的染料，会在血脑屏障受损的大脑区域积聚。这种质量使其成为高级神经胶质瘤（HGG）术中可视化的理想染料。作者报告了他们在手术显微镜上使用专用滤光片的新型荧光素引导技术切除HGG的经验。方法：作者于2011年9月启动了一项前瞻性II期临床试验（FLUOGLIO），旨在评估荧光素引导下的HGG手术的安全性，并获得有关其用于此目的疗效的初步证据。为了有资格参与研究，患者必须怀疑HGG能够完成对造影剂增强区域的切除。本报告基于对2011年9月以来入选的20例HGG（年龄在45-74岁之间）连续患者的短期和长期结果的分析。在所有情况下，荧光素（5-10 mg /插管后静脉注射。通过显微外科技术和在Pentero显微镜上的BLUE 400或YELLOW 560滤光片进行荧光可视化来进行肿瘤切除。结果：术前中位肿瘤体积为30.3 cm3（范围为2.4-87.8 cm3）。没有与荧光素给药有关的不良反应。 80％的患者完全清除了增强造影剂的肿瘤。中位随访时间为10个月。 6个月无进展生存率为71.4％，中位生存期为11个月。结论：对这20例病例的分析表明，在手术显微镜上使用专用滤光片的荧光素引导技术是安全的，并且如术后早期MRI所确定的，可以高比率地完全切除对比增强的肿瘤。临床试验注册号：2011-002527-18（EudraCT）。

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