Aminolevulinic acid-induced photodynamic therapy: safe and effective ablation of dysplasia in Barrett's esophagus.

Abstract

Photodynamic therapy (PDT) is a treatment in which cell damage is achieved by the action of light on a photosensitizer. The aim of this study was to assess the value of PDT in the treatment of Barrett's esophagus with low-grade dysplasia (LGD). Forty patients with dysplastic Barrett's esophagus were given aminolevulinic acid (ALA) 30 mg/kg orally followed 4 h later by laser endoscopy. Follow-up endoscopy and biopsies were performed at 1, 6 and 12 months. A macroscopic response was seen in 33 out of 40 patients, with a median decrease in columnar epithelial area of 30% (range 0-90%). Post-treatment biopsies showed no dysplasia in 39 out of 40 patients, with LGD remaining in one case. This was maintained at 6 and 12 months. There were no significant side-effects. This study demonstrates that ALA-induced PDT provides safe and effective ablation therapy for Barrett's esophagus and is particularly useful against dysplasia.

• Authors: R Ackroyd, N J Brown, M F Davis, T J Stephenson, C J Stoddard, M W Reed
• Journal: Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus (Dis Esophagus) Vol. 13 Issue 1 Pg. 18-22 ( 2000) ISSN: 1120-8694 [Print] United States
• PMID: 11005326 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Photosensitizing Agents
• Aminolevulinic Acid

Topics

• Aminolevulinic Acid (therapeutic use)
• Barrett Esophagus (drug therapy, pathology)
• Follow-Up Studies
• Humans
• Photochemotherapy
• Photosensitizing Agents (therapeutic use)