KEY TAKEAWAYS
- The study aimed to examine the safety, feasibility, and financial impact of using 5-ALA pharmacological equivalent in FGR for CNS tumors.
- The study revealed that despite the marginally higher expenses, FGR with 5-ALA equivalent offers cost-effective solutions globally, benefiting healthcare systems worldwide.
Over the past 20 years, 5-aminolevulinic acid (5-ALA) fluorescence-guided resection (FGR) has become integral to treating malignant gliomas, a form of brain cancer. Its applications have expanded to include metastases and meningiomas, yet its accessibility and cost-effectiveness remain barriers to broader adoption.
Erasmo Barros da Silva Jr and the team conducted a study that aimed to present findings from a retrospective study of 707 cases of CNS tumors undergoing FGR with the pharmacological equivalent of 5-ALA, exploring financial, feasibility, and safety considerations.
Between December 2015 and February 2024, researchers conducted a retrospective analysis of 707 cases of 5-ALA FGR at a single institution. They recorded age, gender, 5-ALA dosage, intraoperative fluorescence findings, diagnosis, adverse effects, and financial impact on surgical treatment costs.
The results revealed an additional estimated cost of $300 per case, representing an increase from 2.37% to 3.28% of the total hospitalization cost. Among the cases, 19 (2.69%) individuals experienced asymptomatic photosensitive reactions, while 2 (0.28%) required symptomatic treatment for photosensitive reactions, and 1 (0.14%) patient developed a cutaneous rash lasting up to 10 days. No other method-related complications were observed. Additionally, in 3 (0.42%) cases of patients with intracranial hypertension, vomiting occurred following administration.
The study concluded that FGR with the pharmacological equivalent of 5-ALA is both safe and efficient despite a minor rise in hospital expenses. This approach presents a dependable solution for circumventing prohibitive costs globally, particularly in regions lacking access to commercial 5-ALA.
No funding was provided.
Source: https://link.springer.com/article/10.1007/s11060-024-04698-z
da Silva Jr, E.B., Ramina, R., Novak Filho, J.L. et al. (2024). “Pharmaceutical equivalent 5-aminolevulinic acid fluorescence guided resection of central nervous system tumors: feasibility, safeness and cost-benefit considerations.” J Neurooncol (2024). https://doi.org/10.1007/s11060-024-04698-z
