5 years ago

Fluorescein-guided surgery for resection of high-grade gliomas: A multicentric prospective phase II study (FLUOGLIO).

Schiariti, Anghileri, Boffano, Cavallo, Broggi, Ferroli, Eoli, De Laurentis, La Corte, Servida, Bosio, Brawanski, Montomoli, Visintini, Pollo, Broggi, Schebesch, Höhne, Acerbi
Purpose Sodium Fluorescein is a dye that, intravenously injected, selectively accumulates in high-grade glioma (HGG) tissue through a damaged blood-brain barrier. In this paper, the final results of a multicentric prospective phase II trial (FLUOGLIO) on fluorescein-guided HGG resection through a dedicated filter on the surgical microscope were reported. Methods Patients with suspected HGG considered suitable for removal were eligible to participate in this trial. Fluorescein was intravenously injected at a dose of 5-10 mg/Kg. Primary endpoint was the percentage of patients with histologically-confirmed HGG, without contrast-enhancing tumor at the immediate post-operative MRI. Secondary endpoints were progression free survival (PFS), residual tumor on postoperative MRI, overall survival, neurological deficits and fluorescein-related toxicity. The sensitivity and specificity of fluorescein in identifying tumor tissue were estimated by fluorescent and non-fluorescent biopsies at the tumor margin. The study was registered on the European Regulatory Authorities website (EudraCT 2011-002527-18). Results Fifty-seven patients aged 45-75 years were screened for participation and 46 were considered for primary and secondary endpoints. Mean pre-operative tumor volume was 28.75 cm3 (range 1.3-87.8 cm3). Thirty-eight patients (82.6%) underwent a complete tumor removal. Median follow-up was 11 months. PFS-6 and PFS-12 were 56,6% and 15.2%. Median survival was 12 months. No adverse reaction related to SF administration was recorded. The sensitivity and specifity of fluorescein in identifying tumor tissue were respectively 80.8% and 79.1%. Conclusion Fluorescein-guided technique with a dedicated filter on the surgical microscope is safe and enables a high percentage of contrast-enhancing tumor in patients with HGG.

Publisher URL: http://doi.org/10.1158/1078-0432.CCR-17-1184

DOI: 10.1158/1078-0432.CCR-17-1184

You might also like
Discover & Discuss Important Research

Keeping up-to-date with research can feel impossible, with papers being published faster than you'll ever be able to read them. That's where Researcher comes in: we're simplifying discovery and making important discussions happen. With over 19,000 sources, including peer-reviewed journals, preprints, blogs, universities, podcasts and Live events across 10 research areas, you'll never miss what's important to you. It's like social media, but better. Oh, and we should mention - it's free.

  • Download from Google Play
  • Download from App Store
  • Download from AppInChina

Researcher displays publicly available abstracts and doesn’t host any full article content. If the content is open access, we will direct clicks from the abstracts to the publisher website and display the PDF copy on our platform. Clicks to view the full text will be directed to the publisher website, where only users with subscriptions or access through their institution are able to view the full article.