ReviewCureus2025
Role of 5-Aminolevulinic Acids in Brain Tumor Surgeries in Pediatrics: A Systematic Review of Case Reports and Series.
Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
0 citing papers in PubMed.
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Pediatric brain tumors remain a leading cause of cancer-related mortality in children, and achieving complete tumor resection is critical for improving survival and neurological outcomes. Fluorescence-guided surgery using 5-aminolevulinic acid (5-ALA) has emerged as a promising adjunct to enhance intraoperative visualization of tumor margins and improve surgical precision in pediatric patients. This systematic review evaluates the safety and efficacy of 5-ALA-guided surgery in pediatric brain tumors, with emphasis on fluorescence visibility, extent of resection, surgical morbidity, and oncological outcomes. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive literature search was conducted across PubMed, Embase, Medline, and Web of Science, identifying 19 studies reporting pediatric cases undergoing 5-ALA-assisted tumor resection. Data regarding patient demographics, tumor characteristics, surgical outcomes, recurrence rates, and complications were extracted and analyzed. A total of 282 pediatric patients with a mean age of 13 years were included, with glioblastomas, medulloblastomas, astrocytomas, and ependymomas being the most common tumor types. Intraoperative fluorescence was observed in 72% of cases, contributing to improved tumor delineation and facilitating more complete resections. Gross total resection was achieved in 77% of patients, of whom 85% demonstrated no tumor recurrence during follow-up periods ranging from three months to five years. Surgical complications occurred in approximately 10% of cases and were predominantly transient neurological deficits. Tumor recurrence was reported in 8% of patients, while overall mortality was 5%, largely associated with aggressive tumor subtypes. Overall, 5-ALA was well tolerated with minimal adverse effects. These findings suggest that 5-ALA fluorescence-guided surgery is a safe and effective adjunct in pediatric brain tumor surgery, enhancing tumor visualization and the extent of resection. Further prospective studies are warranted to establish pediatric-specific protocols and to optimize long-term surgical and oncological outcomes in this vulnerable population.
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