Project: Research project

Project Details


DESCRIPTION: (Applicant's Description) The long term goal of this project
is to assess the use of photodynamic therapy as a treatment for Barrett's
esophagus. Barrett's esophagus is a pre-malignant condition that is being
diagnosed in up to 18 percent of patients undergoing endoscopy. It is felt
to be responsible for distal esophageal and proximal gastric cancers which
are currently the most rapidly increasing tumor in the United States among
men. With greater recognition and screening of this condition, the
significance and management of superficial neoplastic lesions has become a
frequent clinical dilemma. Photodynamic therapy (PDT) would be an ideal
alternative therapy to traditional surgical resection since the esophagus
can easily be accessed by commonly available endoscopes and treatment can be
delivered with simple optical fiber technology with preservation of gut
function as opposed to a costly, debilitating, and difficult operation. The
effect of photodynamic therapy can be targeted to the mucosa where the
neoplastic Barrett's epithelium is initially confined. We have shown that
photodynamic therapy can cause regression of large segments of Barrett's
esophagus with regeneration of normal squamous mucosa. Unique methods will
be use to deliver this therapy. Drug dosimetry will be controlled using a
novel fluorescence probe to determine tissue levels of the photosensitizer.
Light dosimetry will be improved by utilizing a balloon centering device to
flatten the esophageal mucosa. The most important issue regarding PDT will
be to assess whether treatment can alter the biological behavior of
Barrett's epithelium. The development of PDT as a therapy for Barrett's
esophagus could prevent the development of distal esophageal and proximal
gastric cancers and provide unique information regarding the relationship of
dysplasia to biological behavior of the cells.
Effective start/end date9/30/969/29/98


  • Medicine(all)