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Canadian Journal of Gastroenterology
Volume 20, Issue 4, Pages 261-264
Original Article

Photodynamic Therapy in Barrett’s Esophagus: Results of Treatment of 17 Patients

Alan A Weiss,1 Holly AR Wiesinger,2 and David Owen3

1British Columbia Cancer Agency, Vancouver, British Columbia, Canada
2University of British Columbia, Vancouver, British Columbia, Canada
3Department of Pathology, University of British Columbia, Vancouver, British Columbia, Canada

Received 6 July 2005; Accepted 22 November 2005

Copyright © 2006 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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.