Photodynamic therapy of dysplasia and early cancer in Barrett's esophagus using a diode laser system - a pilot study

Background: Photodynamic therapy (PDT) of dysplasia and early cancer of the esophagus could show good results in the potential of ablation. Unfortunat ely. the existing expensive and temperamental dye laser systems foiled a br oad clinical use. In this pilot study, we investigated thr feasibility of a n inexpensive and maintenance-free diode laser system for PDT of dysplasia and early cancer in Barrett's esophagus. Patients and Methods: Eight patients with Barrett's esophagus and/or early cancer were treated. As light sourer we used a diode laser system with a ma ximum power output of 2 W and a wavelength of 633 +/- 3 nm. One patient was treated initially with Photosan-3(R), seven patients received 5-aminolevul inic acid. Results: In all patients we could achieve reduction in length and/or histol ogically proven downgrading. In three quarters of the patients, complete er adication of adenocarcinoma could be attained. Columnar-lined metaplastic e pithelium could also be completely eradicated. Conclusion: PDT using a diode laser system is comparable effective in Barre tt's esophagus/early cancer as PDT with dye laser systems. PDT is a gentle and effective technique with little side effects.