title: Photodynamic therapy in Barrett's esophagus: results of treatment of 17 patients.
abstract: BACKGROUND
  Barrett's esophagus (BE) with dysplasia may progress to esophageal adenocarcinoma. Photodynamic therapy is a promising treatment for BE.
  
  
  OBJECTIVE
  To determine if photodynamic therapy is an acceptable alternative to esophagectomy in BE patients with high-grade dysplasia or early adenocarcinoma.
  
  
  METHODS
  Seventeen patients were treated with photodynamic therapy for BE and high-grade dysplasia or early esophageal adenocarcinoma. Patients with residual Barrett's epithelium were treated with supplemental argon plasma coagulation or potassium titanyl phosphate laser. Patients underwent follow-up endoscopy three, six, nine and 12 months post-treatment, then every six to 12 months. Mean follow-up was 21 months.
  
  
  RESULTS
  High-grade dysplasia or early adenocarcinoma was completely eliminated in nine of 15 (60%) patients. High-grade dysplasia was downgraded in one patient, persisted in one patient and progressed in four patients. Two patients with early esophageal adenocarcinoma were nonresponders. Complications included stricture, sunburn, urticaria, small pleural effusions, esophageal spasm and transient atrial fibrillation.
  
  
  CONCLUSIONS
  Photodynamic therapy with supplemental ablation is a good, noninvasive therapy for elimination of high-grade dysplasia and early adenocarcinoma in BE. Failure to eliminate dysplastic epithelium occurred in 40% of the patients, thereby necessitating careful follow-up.
authors.affiliation: British Columbia Cancer Agency, Vancouver, British Columbia V5Z 4E6. aweiss@bccance.bc.ca
authors.forename: Alan A
authors.initials: AA
authors.lastname: Weiss
authors.forename: Holly A R
authors.initials: HA
authors.lastname: Wiesinger
authors.forename: David
authors.initials: D
authors.lastname: Owen
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000517:prevention & control; D000368:Aged; D000369:Aged, 80 and over; D001471:Barrett Esophagus / Q000188:drug therapy* / Q000473:pathology; D017323:Dihematoporphyrin Ether / Q000627:therapeutic use*; D016099:Endoscopy, Gastrointestinal; D004938:Esophageal Neoplasms / Q000473:pathology / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011230:Precancerous Conditions; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D017319:Photosensitizing Agents; D017323:Dihematoporphyrin Ether