TY - JOUR
T1 - Photodynamic therapy in Barrett's esophagus
AU - Wang, Kenneth K.
AU - Kim, John Y.
N1 - Funding Information:
The authors would like to acknowledge the support of NIH grants CA85992-01 and CA097048-01 and of the Mayo Foundation.
PY - 2003/7
Y1 - 2003/7
N2 - Photodynamic therapy (PDT) was one of the earliest ablative techniques applied to Barrett's esophagus. The rationale for this use was the ability to treat large amounts of esophageal mucosa in a single rapid application. Additionally, PDT has the ability to treat early carcinoma and dysplastic tissue. Because a small carcinoma in dysplastic Barrett's esophagus cannot not be excluded, PDT therapy is a reasonable treatment in this setting. The treatment involves the use of a light and drug combination that must be administered with close attention to dosimetry, since tissue effects of the therapy are delayed and cannot be observed at the time of treatment. Drug administration of sodium porfimer should precede photoradiation by 48 hours. Overall results with this treatment have been good. Case series have established a success rate of 88% to 100% in elimination of high-grade dysplasia. The only randomized multi-center prospective trial in the treatment of Barrett's esophagus with high-grade dysplasia has established that the treatment eliminates high-grade dysplasia better than administration of proton pump inhibitors alone. Unfortunately, there are significant adverse events, including cutaneous photosensitivity, odynophagia, stricture formation, and lack of response.
AB - Photodynamic therapy (PDT) was one of the earliest ablative techniques applied to Barrett's esophagus. The rationale for this use was the ability to treat large amounts of esophageal mucosa in a single rapid application. Additionally, PDT has the ability to treat early carcinoma and dysplastic tissue. Because a small carcinoma in dysplastic Barrett's esophagus cannot not be excluded, PDT therapy is a reasonable treatment in this setting. The treatment involves the use of a light and drug combination that must be administered with close attention to dosimetry, since tissue effects of the therapy are delayed and cannot be observed at the time of treatment. Drug administration of sodium porfimer should precede photoradiation by 48 hours. Overall results with this treatment have been good. Case series have established a success rate of 88% to 100% in elimination of high-grade dysplasia. The only randomized multi-center prospective trial in the treatment of Barrett's esophagus with high-grade dysplasia has established that the treatment eliminates high-grade dysplasia better than administration of proton pump inhibitors alone. Unfortunately, there are significant adverse events, including cutaneous photosensitivity, odynophagia, stricture formation, and lack of response.
UR - http://www.scopus.com/inward/record.url?scp=0041315436&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0041315436&partnerID=8YFLogxK
U2 - 10.1016/S1052-5157(03)00049-7
DO - 10.1016/S1052-5157(03)00049-7
M3 - Review article
C2 - 14629104
AN - SCOPUS:0041315436
SN - 1052-5157
VL - 13
SP - 483
EP - 489
JO - Gastrointestinal Endoscopy Clinics of North America
JF - Gastrointestinal Endoscopy Clinics of North America
IS - 3
ER -