Photodynamic therapy in Barrett's esophagus

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)483-489
Number of pages7
JournalGastrointestinal Endoscopy Clinics of North America
Volume13
Issue number3
DOIs
StatePublished - Jul 2003

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Barrett Esophagus
Photochemotherapy
Therapeutics
Dihematoporphyrin Ether
Carcinoma
Light
Proton Pump Inhibitors
Drug Combinations
Cell- and Tissue-Based Therapy
Pathologic Constriction
Skin
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Gastroenterology
  • Surgery

Cite this

Photodynamic therapy in Barrett's esophagus. / Wang, Kenneth Ke Ning; Kim, John Y.

In: Gastrointestinal Endoscopy Clinics of North America, Vol. 13, No. 3, 07.2003, p. 483-489.

Research output: Contribution to journalArticle

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