Burn, freeze or photo-ablate? Comparative symptom profile in Barrett's dysplasia patients undergoing endoscopic ablation

Kanwar Rupinder S. Gill, Seth A. Gross, Bruce D. Greenwald, Lois L. Hemminger, Herbert C. Wolfsen

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

Background: There are few data available comparing endoscopic ablation methods for Barrett's esophagus with high-grade dysplasia (BE-HGD). Objective: To determine differences in symptoms and complications associated with endoscopic ablation. Design: Prospective observational study. Setting: Two tertiary care centers in USA. Patients: Consecutive patients with BE-HGD Interventions: In this pilot study, symptoms profile data were collected for BE-HGD patients among 3 endoscopic ablation methods: porfimer sodium photodynamic therapy, radiofrequency ablation and low-pressure liquid nitrogen spray cryotherapy. Main Outcome Measurements: Symptom profiles and complications from the procedures were assessed 1-8 weeks after treatment. Results: Ten BE-HGD patients were treated with each ablation modality (30 patients total; 25 men, median age: 69 years (range 53-81). All procedures were performed in the clinic setting and none required subsequent hospitalization. The most common symptoms among all therapies were chest pain, dysphagia and odynophagia. More patients (n=8) in the porfimer sodium photodynamic therapy group reported weight loss compared to radio-frequency ablactation (n=2) and cryotherapy (n=0). Four patients in the porfimer sodium photodynamic therapy group developed phototoxicity requiring medical treatment. Strictures, each requiring a single dilation, were found in radiofrequency ablactation (n=1) and porfimer sodium photodynamic therapy (n=2) patients. Limitations: Small sample size, non-randomized study. Conclusions: These three endoscopic therapies are associated with different types and severity of post-ablation symptoms and complications.

Original languageEnglish (US)
Title of host publication12th World Congress of the International Photodynamic Association - Photodynamic Therapy
Subtitle of host publicationBack to the Future
DOIs
StatePublished - Dec 1 2009
Event12th World Congress of the International Photodynamic Association - Photodynamic Therapy: Back to the Future - Seattle, WA, United States
Duration: Jun 11 2009Jun 15 2009

Publication series

NameProgress in Biomedical Optics and Imaging - Proceedings of SPIE
Volume7380
ISSN (Print)1605-7422

Other

Other12th World Congress of the International Photodynamic Association - Photodynamic Therapy: Back to the Future
CountryUnited States
CitySeattle, WA
Period6/11/096/15/09

Keywords

  • Barrett's esophagus
  • cryotherapy
  • photodynamic therapy
  • radiofrequency ablation

ASJC Scopus subject areas

  • Electronic, Optical and Magnetic Materials
  • Biomaterials
  • Atomic and Molecular Physics, and Optics
  • Radiology Nuclear Medicine and imaging

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    Gill, K. R. S., Gross, S. A., Greenwald, B. D., Hemminger, L. L., & Wolfsen, H. C. (2009). Burn, freeze or photo-ablate? Comparative symptom profile in Barrett's dysplasia patients undergoing endoscopic ablation. In 12th World Congress of the International Photodynamic Association - Photodynamic Therapy: Back to the Future [73804J] (Progress in Biomedical Optics and Imaging - Proceedings of SPIE; Vol. 7380). https://doi.org/10.1117/12.822827