Abstract
Malignant gliomas are extremely difficult to treat with no specific curative treatment. On the other hand, photodynamic medicine represents a promising technique for neurosurgeons in the treatment of malignant glioma. The resection rate of malignant glioma has increased from 40% to 80% owing to 5-aminolevulinic acid-photodynamic diagnosis (ALA-PDD). Furthermore, ALA is very useful because it has no serious complications. Based on previous research, it is apparent that protoporphyrin IX (PpIX) accumulates abundantly in malignant glioma tissues after ALA administration. Moreover, it is evident that the mechanism underlying PpIX accumulation in malignant glioma tissues involves an abnormality in porphyrin-heme metabolism, specifically decreased ferrochelatase enzyme activity. During resection surgery, the macroscopic fluorescence of PpIX to the naked eye is more sensitive than magnetic resonance imaging, and the alert real time spectrum of PpIX is the most sensitive method. In the future, chemotherapy with new anticancer agents, immunotherapy, and new methods of radiotherapy and gene therapy will be developed; however, ALA will play a key role in malignant glioma treatment before the development of these new treatments. In this paper, we provide an overview and present the results of our clinical research on ALA-PDD.
Highlights
Malignant gliomas consist of anaplastic astrocytoma (WHO grade III) and glioblastoma (WHO grade IV) and possess a lethal prognosis
aminolevulinic acid-photodynamic diagnosis (ALA-photodynamic diagnosis (PDD)) has succeeded in increasing the resection rate of malignant glioma from 40% to 80%
PDD significantly prolongs the interval until recurrence
Summary
Malignant gliomas consist of anaplastic astrocytoma (WHO grade III) and glioblastoma (WHO grade IV) and possess a lethal prognosis. Radiotherapy, and chemotherapy, the median survival time for a patient with glioblastoma is only 15.0 months, and it is not much better for patients with anaplastic astrocytoma [1]. The resection rate of glioma is believed to affect patient prognosis. The Committee of Brain Tumor Registry of Japan reported on the relationship between the resection rate of malignant glioma and patient survival time. After total resection of the tumor, the 5-year survival rate was 20.4%; after resecting 50% of the tumor, the 5-year survival rate was 3.8% [1]. Total resection of the tumor means that the enhancing tumor shadow completely disappears on magnetic resonance imaging (MRI) after surgery
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
