The role of photodynamic therapy in the esophagus.
Photodynamic therapy (PDT) is a drug and device therapy using photosensitizer drugs activated by laser light for mucosal ablation. Porfimer sodium PDT has been used extensively with proven long-term efficacy and durability for the ablation of Barrett esophagus and high-grade dysplasia. and early esophageal adenocarcinoma. However, continued use is hampered by an associated stricture risk and prolonged photosensitivity (4-6 weeks). Promising single-center European studies using other forms of PDT, such as aminolevulinic acid PDT, have not been replicated elsewhere, limiting the widespread use of other forms of PDT. Future use of PDT in esophageal disease depends on the development of improved dosimetry and patient selection to optimize treatment outcomes, while minimizing adverse events and complications.
Gross
Seth A
SA
Division of Gastroenterology, Norwalk Hospital, Norwalk, CT 06856, USA.
Wolfsen
Herbert C
HC
D000230:Adenocarcinoma / Q000188:drug therapy*; D000622:Aminolevulinic Acid / Q000627:therapeutic use; D001471:Barrett Esophagus / Q000188:drug therapy*; D017323:Dihematoporphyrin Ether / Q000009:adverse effects / Q000627:therapeutic use; D004938:Esophageal Neoplasms / Q000188:drug therapy*; D006801:Humans; D008652:Mesoporphyrins / Q000627:therapeutic use; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000009:adverse effects / Q000627:therapeutic use*
D008652:Mesoporphyrins; D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid; D017323:Dihematoporphyrin Ether; C072269:temoporfin