R. Ackroyd et al., Aminolevulinic acid-induced photodynamic therapy: safe and effective ablation of dysplasia in Barrett's esophagus, DIS ESOPHAG, 13(1), 2000, pp. 18-22
Photodynamic therapy (PDT) is a treatment in which cell damage is achieved
by the action of light on a photosensitizer. The aim of this study was to a
ssess the value of PDT in the treatment of Barrett's esophagus with low-gra
de dysplasia (LGD). Forty patients with dysplastic Barrett's esophagus were
given aminolevulinic acid (ALA) 30 mg /kg orally followed 4 h later by las
er endoscopy. Follow-up endoscopy and biopsies were performed at 1, 6 and 1
2 months. A macroscopic response was seen in 33 out of 40 patients, with a
median decrease in columnar epithelial area of 30% (range 0-90%). Post-trea
tment biopsies showed no dysplasia in 39 out of 40 patients, with LGD remai
ning in one case. This was maintained at 6 and 12 months. There were no sig
nificant side-effects. This study demonstrates that ALA-induced PDT provide
s safe and effective ablation therapy for Barrett's esophagus and is partic
ularly useful against dysplasia.