Glioblastoma (GB) is among the most aggressive and difficult-to-treat brain tumors, with a median survival of only 12–15 months despite maximal treatments, including surgery, radiotherapy, and chemotherapy. Extensive surgical resection improves survival in glioblastoma patients; however, achieving complete resection is often hindered by limitations in neurosurgical guidance technologies for accurate tumor margin detection. Recent advancements in fluorescence-guided surgery (FGS) and imaging techniques have significantly enhanced the precision and extent of glioblastoma resections. This study evaluates the impact of NIR fluorescence imaging on tumor visualization, surgical precision, cost-effectiveness, and patient survival. A systematic review of PubMed, Scopus, Google Scholar, and Embase was conducted to identify studies on the role of NIR fluorescence in glioblastoma surgery. A total of 135 studies were included, comprising 10 reviews, three clinical studies, 10 randomized controlled trials (RCTs), 10 preclinical studies, and four case reports, all focused on NIR fluorescence imaging in glioblastoma surgery. The findings indicate that NIR fluorescence imaging significantly improves tumor visualization, resulting in an 18–22% increase in gross total resection (GTR) rates in clinical studies. NIR fluorescence provides continuous real-time feedback, minimizing repeat imaging, reducing operational costs, and increasing GTR. These improvements contribute to better patient outcomes, including extended progression-free survival, improved overall survival, and reduced postoperative neurological deficits. This review underscores the potential of NIR imaging to establish a new standard for intraoperative glioblastoma management.
胶质母细胞瘤（GB）是最具侵袭性且治疗难度极高的脑肿瘤之一，即使接受包括手术、放疗和化疗在内的最大程度治疗，患者中位生存期仅为12-15个月。扩大手术切除范围可改善胶质母细胞瘤患者的生存预后，但由于神经外科引导技术在精确识别肿瘤边界方面存在局限，实现完全切除往往面临挑战。近年来荧光引导手术（FGS）与成像技术的进步显著提升了胶质母细胞瘤切除的精准度和范围。本研究系统评估了近红外荧光成像对肿瘤可视化、手术精准度、成本效益及患者生存的影响。通过对PubMed、Scopus、Google Scholar和Embase数据库进行系统性文献回顾，共纳入135项聚焦近红外荧光在胶质母细胞瘤手术中应用的研究，包括10篇综述、3项临床研究、10项随机对照试验（RCT）、10项临床前研究及4例病例报告。研究结果表明，近红外荧光成像显著改善肿瘤可视化，临床研究中大体全切率（GTR）提升18-22%。该技术提供连续实时反馈，最大限度减少重复成像，降低手术成本并提高GTR率。这些改进有助于改善患者预后，包括延长无进展生存期、提高总生存率以及减少术后神经功能缺损。本综述揭示了近红外成像技术为胶质母细胞瘤术中管理建立新标准的潜力。
Enhancing Glioblastoma Resection with NIR Fluorescence Imaging: A Systematic Review
肿瘤(癌症)患者之家