Charles S. Cobbs, MD
The Gregory Foltz, MD Endowed Director
Ben & Catherine Ivy Center for
Advanced Brain Tumor Treatment
Swedish Neuroscience Specialists
Investigators from Sloan-Kettering and the Fred Hutchinson Cancer Institute have published recently a technology that may increase our ability to perform a more complete and accurate resections of malignant brain tumors. http://www.acs.org/content/acs/en/pressroom/presspacs/2014/acs-presspac-september-3-2014/handheld-scanner-could-make-brain-tumor-removal-more-complete-reducing-recurrence.html
Using a technology whereby small particles (nano particles) light off when exposed to certain light frequencies, the investigators have shown that these particles can congregate in the tumor cells which can be visualized in the presence of a specific kind of light source. This research shows the feasibility of enhancing the visualization of tumor cells which are difficult to see during normal surgical procedures since they can blend in with the normal brain tissue. These studies were done in mice, yet this technology should theoretically be able to be performed in humans. This technology is similar to one being exploited currently in Europe and in some experimental centers in the United States, which uses the intravenous administration of a compound known as 5-ala, which will light up in the presence of fluorescent light in tumor cells but not normal brain tissue. Studies have shown that more complete resections using 5-ala are achievable, and analysis of these studies suggest that this increase in our ability to resect tumors using this technology may improve survival in glioblastoma patients who have had more complete resections.
Studies have not been proved in a prospective class I evidence type of mechanism and this is considered class II evidence, ie., supportive but not definitive. Also, we are not talking about dramatic improvement in survival in these patients, but improvements of a few months possibly. Nevertheless, given the overall dismal prognosis of glioblastoma at this point, any improvement in survival and any new technologies that can achieve this should be lauded. The investigators at Sloan-Kettering and the Fred Hutchinson cancer Institute will hopefully translate these studies into humans to see if they are feasible soon.
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