Endoscopy 2003; 35(6): 496-501
DOI: 10.1055/s-2003-39676
Original Article
© Georg Thieme Verlag Stuttgart · New York

Eradication of Dysplastic Barrett’s Oesophagus Using Photodynamic Therapy: Long-Term Follow-Up

R.  Ackroyd 1 , C.  J.  Kelty 2 , N.  J.  Brown 2 , T.  J.  Stephenson 3 , C.  J.  Stoddard 1 , M.  W. R.  Reed 2
  • 1 Department of Surgery, Sheffield Teaching Hospitals, Sheffield, UK
  • 2 Academic Unit of Surgical Oncology, University of Sheffield, Royal Hallamshire Hospital, Sheffield, UK
  • 3 Department of Histopathology, Sheffield Teaching Hospitals, Sheffield, UK
Further Information

Publication History

Submitted 9 May 2002

Accepted after Revision 19 November 2002

Publication Date:
03 June 2003 (online)

Background and Study Aims: Barrett’s oesophagus is a major risk factor for oesophageal adenocarcinoma, a condition which is rapidly increasing in incidence. Photodynamic therapy (PDT) is a developing treatment in which tissue damage is caused by the action of light on a previously administered photosensitizing agent. We present the results of long-term follow-up of its efficacy in patients with dysplastic Barrett’s oesophagus.
Patients and Methods: A total of 40 patients with low-grade dysplasia in Barrett’s oesophagus were treated with oral 5-aminolaevulinic acid (ALA) at a dose of 30 mg/kg, followed by laser endoscopy 4 hours later. Patients were treated between December 1995 and December 1998, and all were followed up regularly with endoscopy and biopsies in our surveillance programme.

Results: Among the patients, 35 (88 %) showed a macroscopic reduction in the area of the columnar epithelium, and in all 40 patients dysplasia was found to be eradicated at 1 month. The effect has been maintained for a median follow-up of 53 months (range 18 - 68 months), although one patient developed a late carcinoma in an untreated area of Barrett’s oesophagus 3 years after the intervention.
Conclusions: Safe and effective ablation of low-grade dysplastic Barrett’s oesophagus can be achieved with the use of ALA-induced PDT, and the effects are maintained in the long term.

References

R. Ackroyd, M.D.

Department of Surgery, K Floor

Royal Hallamshire Hospital · Glossop Road · Sheffield, S10 2JF · UK

Fax: + 44-114-2713791

Email: r.ackroyd@sheffield.ac.uk