The Use of 5-ALA in Paediatric Patients With High Grade Brain Tumours

Inclusion Criteria: * Magnetic Resonance Imaging confirmation of diagnosis consistent with either: primary presentation of high grade brain tumour OR patient relapsing with previously confirmed ependymoma or high-grade glial tumour * Tumours will be either intrinsic supratentorial or infratentorial / posterior fossa, non-brainstem, tumours * Patient is appropriate for maximal safe resection of tumour, based on Investigator and Multidisciplinary Team judgement * 3 - 18 years inclusive * Adequate liver and kidney function * creatinine - less than one and a half times the upper limit of normal. * haemoglobin above the lower limit of normal * Alanine transferase or Aspartate transferase less than twice the upper limit of normal (if both performed, then both results must be lower than twice the upper limit of normal * bilirubin lower than one and a half times the upper limit of normal * Normal Coagulation profile o Prothombin Time, Activated Partial Prothombin Time and Thrombin Time all within normal limits * Urine porphyrin - Test to be completed and sent for analysis * Blood pressure lower than or equal to the upper limit of normal * Negative pregnancy test in women of childbearing potential\* * Informed Consent \*A positive pregnancy test that is suspected to be due to the location of the tumour is to be queried with the TMG prior to registration of the patient Exclusion Criteria: * Patients with low grade tumours (either radiological or histological diagnosis) * Patient is appropriate for biopsy only, based on Investigator and MDT judgement * Known history (including family history) of porphyria * Hypersensitivity to the active substance or to porphyrins * History of light sensitivity reactions * Pregnant or breastfeeding women