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Aminolaevulinic Acid-induced Photodynamic Therapy in the Treatment of Dysplastic Barrett's Oesophagus and Adenocarcinoma
Authors:R. Ackroyd  N.J. Brown  M.F. Davis  T.J. Stephenson  C.J. Stoddard  M.W.R. Reed
Affiliation:(1) University Department of Surgical and Anaesthetic Sciences, Royal Hallamshire Hospital, Glossop Road, Sheffield, UK, GB;(2) University Department of Medical Physics, Royal Hallamshire Hospital, Glossop Road, Sheffield, UK, GB;(3) University Department of Histopathology, Royal Hallamshire Hospital, Glossop Road, Sheffield, UK, GB
Abstract:
. Photodynamic therapy (PDT) may have a role in the prevention of oesophageal cancer. Ten patients with Barrett's oesophagus, three with low-grade dysplasia (LGD), four with high-grade dysplasia (HGD), one with carcinoma in situ and two with invasive carcinoma, were treated with PDT. All received 30 mg/kg aminolaevulinic acid (ALA) followed 4 h later by laser endoscopy. Half were treated with red light (630 nm; 100 mW/cm2 for 1000 s) and half with green light (514 nm; 100 mW/cm2 for 500 s). Columnar epithelial regression was seen in all patients with dysplasia (mean area decrease 44%; range 10–100%), with apparent elimination of dysplasia in all cases. In patients with in situ or invasive carcinoma, no response was seen. ALA-induced PDT, using either red or green light, produces effective ablation of dysplastic Barrett's oesophagus, hence may have a role in the prevention of oesophageal carcinoma, but has little effect on in situ or invasive adenocarcinoma. Paper received 3 January 1999; accepted after revision 12 April 1999.
Keywords:: Adenocarcinoma   Aminolaevulinic acid   Barrett's oesophagus   Dysplasia   Photodynamic therapy
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