5-Aminolevulinic Acid Fluorescence-Guided Surgery in Diagnosing Primary or Recurrent Head and Neck or Skull Base Cancers
This phase II trial tests how well 5-aminolevulinic acid fluorescence-guided surgery works in diagnosing patients with head or neck cancers that has not spread to other places in the body (primary) or has come back (after a period of improvement) (recurrent). Treatment for many head and neck cancers involves surgical resection, or removal, of the tumor. A potential complication of surgery is subtotal resection, in which some cancerous material fails to be removed. This is a problem because it can negatively impact patient survival and tumor regrowth after surgery. Because head and neck surgery involves aesthetically sensitive parts of the body and many complicated anatomical structures, it can be difficult for surgeons to ensure total tumor resection while minimizing the amount of healthy tissue they have to remove. Fluorescent-guided surgery (FGS) is a new method used to clearly visualize cancerous tissue during surgery in real-time. Before surgery, a medication that preferentially enters tumor cells is given to the patient. Tumor cells then glow brightly when exposed to a particular kind of light during surgery, allowing the surgeon to distinguish between healthy and cancerous tissue. One such agent, 5-aminolevulinic acid (5-ALA), has been successfully used by neurosurgeons for FGS of different brain tumors and has been shown to be safer and more effective than other types of intraoperative imaging. This study may help researchers determine if undergoing surgery with 5-ALA if more effective in diagnosing head and neck or skull base cancers.