Combined endoscopic mucosal resection and photodynamic therapy for esophageal neoplasia within Barrett's esophagus

Navtej Singh Buttar, Kenneth Ke Ning Wang, Lori S. Lutzke, Krishnawatie K. Krishnadath, Marlys A. Anderson

Research output: Contribution to journalArticle

Abstract

Background: Endoscopic mucosal resection (EMR) and photodynamic therapy have been proposed as treatments for early stage cancers. EMR is limited by its focal nature whereas photodynamic therapy is dependent on precise staging. The combination of EMR and photodynamic therapy were studied in the treatment of superficial cancer in patients with Barrett's esophagus. Methods: Seventeen consecutive nonsurgical patients with superficial cancers underwent EMR followed by photodynamic therapy with a porphyrin photosensitizer. Photoradiation was performed at 630 nm for a total dose of 200 J/cm of diffuser. Results: Seventeen patients (15 men; mean age 69 ± 13 years) underwent EMR. The mean diameter of mucosal resection was 1 cm.The margins were involved by cancer in 3 cases. EMR improved staging in 8 patients (47%). Sixteen (94%) patients remained in remission (median follow-up 13 months). Complications included minor bleeding after EMR in 1 patient (6%), stricture in 5 (30%), cutaneous phototoxicity in 2 (12%), and supraventricular tachycardia in 1 patient (6%). Conclusions: Combined EMR and photodynamic therapy appears to be an effective and safe therapy for superficial esophageal cancer within Barrett's esophagus.This combination improves cancer staging, removes the superficial cancer, and eliminates remaining mucosa at risk for cancer development.

Original languageEnglish (US)
Pages (from-to)682-688
Number of pages7
JournalGastrointestinal Endoscopy
Volume54
Issue number6
DOIs
StatePublished - Dec 2001

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Barrett Esophagus
Photochemotherapy
Neoplasms
Phototoxic Dermatitis
Supraventricular Tachycardia
Photosensitizing Agents
Endoscopic Mucosal Resection
Neoplasm Staging
Porphyrins
Esophageal Neoplasms
Pathologic Constriction
Mucous Membrane
Therapeutics
Hemorrhage
Light
Skin

ASJC Scopus subject areas

  • Gastroenterology

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Combined endoscopic mucosal resection and photodynamic therapy for esophageal neoplasia within Barrett's esophagus. / Buttar, Navtej Singh; Wang, Kenneth Ke Ning; Lutzke, Lori S.; Krishnadath, Krishnawatie K.; Anderson, Marlys A.

In: Gastrointestinal Endoscopy, Vol. 54, No. 6, 12.2001, p. 682-688.

Research output: Contribution to journalArticle

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AU - Anderson, Marlys A.

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