Phototherapy of Barrett's esophagus

摘要

Abstract: Barrett's esophagus is a common premalignant disease. The aim of this study is to determine if low dose photodynamic therapy is capable of ablating Barrett's epithelium allowing regrowth of normal squamous mucosa. Methods: Patients with specialized Barrett's esophagus of at least 3 cm length were given 1.5-1.75 mg/kg of hematoporphyrin derivative intravenously. After 48 hours, esophagoscopy and videotaping of the Barrett's was performed. A 1.0-1.5 cm cylindrical diffusing fiber delivered light of 630 nm in a dose of 150-200 J/cm using a tunable dye laser at a power of 400 mW/cm. Following entry, patients were placed on omeprazole 20 mg/day for six months. Results: Twelve patients (8 men) mean age of 62 $POM 4 have had repeat endoscopy performed at 25 $POM 2 weeks following entry. The Barrett's segment length decreased from 8$POM@1 to 5$POM@1 cm after PDT (p $LS 0.01) with a corresponding change in the appearance and location of the squamocolumnar junction. Six (50%) of the patients had a 4 cm or more decrease in the length of their Barrett's esophagus with normal squamous mucosa on biopsy. Adverse events included transient odynophagia, minor sunburn, and transient chest pain. Conclusions: Photodynamic therapy of Barrett's esophagus can cause a regression in length of the Barrett's segment with replacement by normal squamous epithelium. !17