Table 1.
HGG studies with 5-ALA-guided surgery compared to white light surgery.
| Study | Patients (N) | Study Design | Definitions (GTR and Postoperative MRI after Surgery) | Results |
|---|---|---|---|---|
| Stummer et al. (2006) | 322 | Prospective randomized controlled trial | GTR = residual tumor < 0.175 cm3
Postoperative MRI: <72 h |
GTR: 65% vs. 36% (p < 0.0001) * PFS6: 41% vs. 21.1% (p < 0.0003) * OS: 15.2 months vs. 13.5 months (p < 0.1) |
| Diez Valle et al. (2014) | 251 | Retrospective case–control study | GTR = no contrast-enhancing tumor Postoperative MRI: <28 days |
GTR: 67% vs. 45% (p < 0.000) * PFS6: 69% vs. 48% (p < 0.002) * |
| Coburger et al. (2015) | 66 | Retrospective case–control study | GTR ≥ 95% tumor resection Postoperative MRI: <72 h after surgery |
GTR: 99.6% vs. 96.0% (p < 0.004) * Volume: 0.1 cc vs. 1.8 cc (p < 0.02) * OS: 18 months vs. 17 months (p < 0.708) PFS: 6 months vs. 6 months (p < 0.309) |
| Della Puppa et al. (2017) | 122 | Retrospective case–control study | GTR = residual tumor < 0.175 cm3 Postoperative MRI: <24 h |
GTR: 80% (BCNU wafers + 5-ALA) 47% (5-ALA) 76% (BCNU wafers) OS: 22 months (BCNU wafers + 5-ALA) 18 months (5-ALA) 21 months (BCNU wafers) PFS: 11 months (BCNU wafers + 5-ALA) 10 months (5-ALA) 11 months (BCNU wafers) |
Note: * statistically significant p-value < 0.05. 5-ALA = 5-aminolevulinic acid, BCNU = carmustine (1,3-bis(2-chloroethyl)-1-nitrosurea, GTR = gross total resection, N = number, OS = overall survival, PFS = progression-free survival.