Long term follow-up of patients with newly diagnosed glioblastoma treated by intraoperative photodynamic therapy: an...

Area of Science:

• Neurosurgery
• Oncology
• Photomedicine

Background:

• Glioblastoma is an aggressive brain tumor with poor prognosis despite standard treatments.
• Optimal multimodal management for glioblastoma has limited efficacy.
• There is a need for novel therapeutic strategies to improve patient outcomes.

Purpose of the Study:

• To report updated, exploratory analyses of overall survival (OS), progression-free survival (PFS), and health-related quality of life (HRQOL).
• To evaluate the efficacy and safety of intraoperative photodynamic therapy (PDT) with 5-aminolevulinic acid hydrochloride (5-ALA HCl) in glioblastoma patients.
• To assess the long-term outcomes of a standardized therapeutic approach combining 5-ALA HCl fluorescence-guided surgery (FGS) and intraoperative PDT.

Main Methods:

• A single-arm, open-label pilot trial (INDYGO) included ten glioblastoma patients.
• Patients underwent 5-ALA HCl FGS followed by intraoperative PDT (200 J/cm²).
• Adjuvant therapy (Stupp protocol) was administered postoperatively, with follow-up every 3 months.

Main Results:

• Median follow-up was 23 months; no unacceptable toxicities or treatment-related deaths occurred.
• Actuarial 12-month PFS rate was 60%, with a median OS of 23.4 months.
• Actuarial 12-month, 24-month, and 5-year OS rates were 80%, 50%, and 40%, respectively.

Conclusions:

• Intraoperative PDT, combined with maximal surgical excision and adjuvant treatment, appears to increase time to recurrence and overall survival in glioblastoma patients.
• Health-related quality of life was maintained throughout the study without severe side effects.
• The findings suggest PDT is a safe and potentially effective adjunctive therapy for glioblastoma.