EP12.03 «THE USE OF 5-AMINOLEVULINIC ACID IN GLIAL BRAIN TUMORS AND THE ROLE OF COMBINATION THERAPY»

Abstract BACKGROUND Recently, 5-ALA-induced fluorescence has been widely used in glioma surgery. The use of 5-ALA in neurosurgery allows to minimize the tumor volume and reduce neurological deficit, which can lead to an increase in patient survival. Objective: To analyze the survival of patients with glial tumors after microsurgical tumor removal using the drug gliolan (5-ALA). MATERIAL AND METHODS The study included 91 patients with glial brain tumors who underwent microsurgical tumor removal using fluorescence navigation (5 ALA), who were inpatients at the National Center for Neurosurgery in Astana from January 2022 to September 2023. Of these, 43 patients were male, 48 patients were female. The average age was 49.2 years. The age category of patients was from 19 to 77 years. All patients underwent microsurgical removal of the tumor using 5-ALA. RESULTS Of the 91 patients, 1 patient had a glial brain tumor G1, two patients had G2, 14 patients had G3, and 74 patients had G4-74. Total removal of tumors using 5-ALA was achieved in 43 patients, which was 47.2%. Subtotal removal was achieved in 34 patients, 37.6%, and partial removal was achieved in 14 patients, i.e. 15.3% of patients. The overall survival of 91 patients was 35 patients, which is 38.4% up to 3 years after surgery. During the analysis, 53 patients out of 91 received a course of radiotherapy, of which 37 patients received combination therapy with chemotherapy. In the analysis of surviving patients, 27 of 35 received a full course of chemoradiotherapy and only 7 patients did not receive a full course of CRT. CONCLUSION Analysis of 91 patients with glial tumors shows that the use of 5-ALA fluorescence improves the possibility of maximal removal of the brain tumor volume. In addition, the role of complex therapy in the postoperative period plays an important role in the study of survival.