Morphological evaluation of the effectiveness of fluorescence navigation with chlorin e6 in surgery for malignant gliomas

Rynda, A. Yu.; Zabrodskaya, Yu. M.; Olyushin, V. E.; Ростовцев, Д. М.; Соколова, Т. В.; Papayan, G. V.

doi:10.17116/patol20218305113

Cited by 3 publications

(1 citation statement)

References 23 publications

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“…Ce6 is a fluorescence imaging agent that can be used in high-grade glioma surgery. Rynda et al evaluated fluorescence navigation with Ce6, which had proven efficacy in malignant glioma surgery in a comparative morphopathological analysis. Rynda also used this technique in brain glioma surgery, resulting in weak fluorescence in all patients with grade II gliomas and strong fluorescence in almost all patients with grade III–IV gliomas.…”

Section: Other Applications Of Ce6mentioning

confidence: 99%

Antitumor Effect of Photodynamic Therapy/Sonodynamic Therapy/Sono-Photodynamic Therapy of Chlorin e6 and Other Applications

et al. 2023

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Chlorin e6 (Ce6) has been extensively researched and developed as an antitumor therapy. Ce6 is a highly effective photosensitizer and sonosensitizer with promising future applications in photodynamic therapy, dynamic acoustic therapy, and combined acoustic and light therapy for tumors. Ce6 is also being studied for other applications in fluorescence navigation, antibacterials, and plant growth regulation. Here we review the role and research status of Ce6 in tumor therapy and the problems and challenges of its clinical application. Other biomedical effects of Ce6 are also briefly discussed. Despite the difficulties in clinical application, Ce6 has significant advantages in photodynamic therapy (PDT)/sonodynamic therapy (SDT) against cancer and offers several possibilities in clinical utility.

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Section: Other Applications Of Ce6mentioning

confidence: 99%

Antitumor Effect of Photodynamic Therapy/Sonodynamic Therapy/Sono-Photodynamic Therapy of Chlorin e6 and Other Applications

et al. 2023

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Fluorescent diagnostics with chlorin e6 in surgery of low-grade glioma

Rynda

Olyushin

Ростовцев

et al. 2022

Biomedical photonics

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Intraoperative fluorescence diagnostics of high-grade gliomas is widely used in neurosurgical practice. This work analyzes the possibilities of fluorescence diagnostics for low-grade gliomas (LGG) using chlorin e6 photosensitizer. The study included patients with newly diagnosed LGG, for whom chlorin e6 was used for intraoperative fluorescence control at a dose of 1 mg/kg. During the operation, the fluorescence intensity of various areas of the putative tumor tissue was analyzed using the RSS Cam – Endo 1.4.313 software. Tissue samples with various degrees of fluorescence intensity were compared with the results of their histopathological analysis (WHO tumor diagnosis, Ki-67 index, P53, VEGF). Fluorescence was detected in more than half of the cases, but in most cases had a focal character and low fluorescence intensity. The fluorescence intensity directly correlated with the data of histopathological examination of tumor tissues (Ki-67 index (p=0.002), expression of P53 (p=0.0015) and VEGF (p=0.001)). The sensitivity of the method for LGG surgery was 72%, the specificity was 56,7%. Intraoperative fluorescence diagnostics with chlorin e6 can be used in LGG surgery, especially to visualize intratumoral areas with a higher degree of anaplasia.

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Results of microsurgical resection of glioblastomas under endoscopic and fluorescent control

Rynda,

Olyushin,

Rostovtsev

et al. 2024

Biomedical photonics

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Overall survival and recurrence-free survival (RFS) in patients with glioblastoma directly depend on the radicality of tumor resection. According to a number of literature sources, it is known that endoscopic surgeries under ﬂuorescence control increase the rate of total resection. However, until now, there is little data on whether endoscopic resection with ﬂuorescence control aﬀects RFS and overall survival of patients with glioblastoma. The aim of our study was to investigate the eﬀect of intraoperative endoscopic and ﬂuorescence control on overall survival and RFS in patients with glioblastoma. A retrospective single-center analysis was performed in 20 patients with glioblastoma. Ten patients underwent tumor resection using an operating microscope with endoscopic and ﬂuorescence control. In 5 patients, 5-aminolevulinic acid (5-ALA) (alasens) at a dose of 20 mg/ kg was used as a photosensitizer, in 5 patients, chlorin e6 (photoditazine) at a dose of 1 mg/kg. Ten patients underwent resection under endoscopic control, but without ﬂuorescence control. Both cohorts of patients were comparable in age, functional status, tumor localization, adjuvant treatment methods, and molecular status. The criteria for assessing the eﬀectiveness of the study in the groups were: the radicality of the surgical intervention according to postoperative magnetic resonance imaging with contrast enhancement, as well as the median RFS and OS in patients. In the group of combined surgery under microscopic and ﬂuorescence control with an endoscope, the rate of total tumor resection was higher than in the group of patients who underwent only surgery under a microscope and an endoscope without ﬂuorescence control (100% versus 60%; p = 0.002). Median OS (20.2 months (95% CI 11.9-28.6) versus 16.3 months (95% CI 11.0-20.9); (p = 0.003)) and median RFS (11.7 months (95% CI 9.8-15.7) versus 9.8 months (95% CI 6.1-13.4) (p = 0.04)), were also statistically signiﬁcantly higher compared to the group of patients who received treatment to the same extent, but without ﬂuorescence control. As our experience has shown, the use of ﬂuorescence control during tumor resection in patients with glioblastoma with endoscopic assistance is certainly necessary, given the technical capabilities available, as it has a positive eﬀect on the treatment results for this category of patients.

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Morphological evaluation of the effectiveness of fluorescence navigation with chlorin e6 in surgery for malignant gliomas

Cited by 3 publications

References 23 publications

Antitumor Effect of Photodynamic Therapy/Sonodynamic Therapy/Sono-Photodynamic Therapy of Chlorin e6 and Other Applications

Antitumor Effect of Photodynamic Therapy/Sonodynamic Therapy/Sono-Photodynamic Therapy of Chlorin e6 and Other Applications

Fluorescent diagnostics with chlorin e6 in surgery of low-grade glioma

Results of microsurgical resection of glioblastomas under endoscopic and fluorescent control

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