[Photodynamic therapy of dysplasias and early carcinomas in Barrett esophagus with 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. Unfortunately, the existing expensive and temperamental dye laser systems foiled a broad clinical use. In this pilot study, we investigated the feasibility of an inexpensive and maintenance-free diode laser system for PDT of dysplasia and early cancer in Barrett's esophagus.


METHODS
Eight patients with Barrett's esophagus and/or early cancer were treated. As light source we used a diode laser system with a maximum power output of 2 W and a wavelength of 633 +/- 3 nm. One patient was treated initially with Photosan-3, seven patients received 5-aminolevulinic acid.


RESULTS
In all patients we could achieve reduction in length and/or histologically proven downgrading. In three quarters of the patients, complete eradication of adenocarcinoma could be attained. Columnar-lined metaplastic epithelium could also be completely eradicated.


CONCLUSIONS
PDT using a diode laser system is comparably effective in Barrett's esophagus/early cancer as PDT with dye laser systems. PDT is a gentle and effective technique with little side effects.
Zöpf
T
T
Medizinische Klinik C, Klinikum der Stadt Ludwigshafen gGmbH. thomas.zoepf@t-online.de
Rosenbaum
A
A
Apel
D
D
Jakobs
R
R
Arnold
J C
JC
Riemann
J F
JF
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000473:pathology; D000368:Aged; D000622:Aminolevulinic Acid / Q000008:administration & dosage; D001471:Barrett Esophagus / Q000188:drug therapy* / Q000473:pathology; D002471:Cell Transformation, Neoplastic / Q000473:pathology*; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D007834:Lasers; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010778:Photochemotherapy / Q000295:instrumentation*; D011230:Precancerous Conditions / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome
D000622:Aminolevulinic Acid