R. Ackroyd et al., Aminolaevulinic acid-induced photodynamic therapy in the treatment of dysplastic Barrett's oesophagus and adenocarcinoma, LASER MED S, 14(4), 1999, pp. 278-285
Photodynamic therapy (PDT) may have a role in the prevention of oesophageal
cancer. Ten patients with Barrett's oesophagus, three with law-grade dyspl
asia (LGD), four with high-grade dysplasia (HGD), one with carcinoma in sit
u and two with invasive carcinoma, were treated with PDT. All received 30 m
g/kg aminolaevulinic acid (ALA) followed 4 h later by laser endoscopy. Half
were treated with red light (630 nm; 100 mW/cm(2) for 1000 s) and half wit
h green light (514 nm; 100 mW/cm(2) for 500 s). Columnar epithelial regress
ion was seen in all patients with dysplasia (mean area decrease 44%; range
10-100%), with apparent elimination of dysplasia in all cases. In patients
with in situ or invasive carcinoma, no response was seen. ALA-induced PDT,
using either red or green light, produces effective ablation of dysplastic
Barrett's oesophagus, hence may have a role in the prevention of oesophagea
l carcinoma, but has little effect on in situ or invasive adenocarcinoma.