Radiofrequency ablation is effective for the treatment of high-grade dysplasia in Barrett's esophagus after failed photodynamic therapy

被引:15
作者
Dunn, J. M. [1 ]
Banks, M. R. [3 ]
Oukrif, D. [2 ]
Mackenzie, G. D. [1 ]
Thorpe, S. [1 ]
Rodriguez-Justo, M. [2 ]
Winstanley, A. [2 ]
Bown, S. G. [1 ]
Novelli, M. R. [2 ]
Lovat, L. B. [1 ,3 ]
机构
[1] UCL, Natl Med Laser Ctr, Dept Surg, London W1W 7EJ, England
[2] UCL, Dept Histopathol, London W1W 7EJ, England
[3] Univ Coll London Hosp NHS Fdn Trust, Dept Gastroenterol, London, England
关键词
FOCAL ABLATION; SAFETY;
D O I
10.1055/s-0030-1256443
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Endoscopic radiofrequency ablation (RFA) is an effective treatment for high-grade dysplasia in Barrett's esophagus in ablation-nave patients, but no studies have evaluated its use in patients in whom ablative therapy has previously failed. We describe 14 patients with residual high-grade dysplasia following aminolevulinic acid or Photofrin (porfimer sodium) photodynamic therapy (PDT). An overall complete reversal of dysplasia was achieved in 86% with a combination of RFA and rescue endoscopic mucosal resection. The median total follow-up is 19 months. The rate of strictures was 7% (1/14) and there was a low rate of buried glands (0.5% follow-up biopsies). These data suggest RFA is both safe and effective for eradication of high-grade dysplasia in patients in whom PDT has failed.
引用
收藏
页码:627 / 630
页数:4
相关论文
共 14 条
[1]   Squamous Overgrowth Is Not a Safety Concern for Photodynamic Therapy for Barrett's Esophagus With High-Grade Dysplasia [J].
Bronner, Mary P. ;
Overholt, Bergen F. ;
Taylor, Shari L. ;
Haggitt, Rodger C. ;
Wang, Kenneth K. ;
Burdick, J. Steven ;
Lightdale, Charles J. ;
Kimmey, Michael ;
Nava, Hector R. ;
Sivak, Michael V. ;
Nishioka, Norman ;
Barr, Hugh ;
Canto, Marcia I. ;
Marcon, Norman ;
Pedrosa, Marcos ;
Grace, Michael ;
Depot, Michelle .
GASTROENTEROLOGY, 2009, 136 (01) :56-64
[2]   Circumferential ablation of Barrett's esophagus that contains high-grade dysplasia: a US multicenter registry [J].
Ganz, Robert A. ;
Overholt, Bergein F. ;
Sharma, Virender K. ;
Fleischer, David E. ;
Shaheen, Nicholas J. ;
Lightdale, Charles J. ;
Freeman, Stephen R. ;
Pruitt, Ronald E. ;
Urayama, Shiro M. ;
Gress, Frank ;
Pavey, Darren A. ;
Branch, M. Stanley ;
Savides, Thomas J. ;
Chang, Kenneth J. ;
Muthusamy, V. Raman ;
Bohorfoush, Anthony G. ;
Pace, Samuel C. ;
DeMeester, Steven R. ;
Eysselein, Viktor E. ;
Panjehpour, Masoud ;
Triadafilopoulos, George .
GASTROINTESTINAL ENDOSCOPY, 2008, 68 (01) :35-40
[3]   Effective treatment of early Barrett's neoplasia with stepwise circumferential and focal ablation using the HALO system [J].
Gondrie, J. J. ;
Pouw, R. E. ;
Sondermeijer, C. M. T. ;
Peters, F. P. ;
Curvers, W. L. ;
Rosmolen, W. D. ;
Ten Kate, F. ;
Fockens, P. ;
Bergman, J. J. .
ENDOSCOPY, 2008, 40 (05) :370-379
[4]   Stepwise circumferential and focal ablation of Barrett's esophagus with high-grade dysplasia: results of the first prospective series of 11 patients [J].
Gondrie, J. J. ;
Pouw, R. E. ;
Sondermeijer, C. M. T. ;
Peters, F. P. ;
Curvers, W. L. ;
Rosmolen, W. D. ;
Krishnadath, K. K. ;
Ten Kate, F. ;
Fockens, P. ;
Bergman, J. J. .
ENDOSCOPY, 2008, 40 (05) :359-369
[5]   Biologic properties of columnar epithelium underneath reepithelialized squamous mucosa in Barrett's esophagus [J].
Hornick, JL ;
Blount, PL ;
Sanchez, CA ;
Cowan, DS ;
Ayub, K ;
Maley, CC ;
Reid, BJ ;
Odze, RD .
AMERICAN JOURNAL OF SURGICAL PATHOLOGY, 2005, 29 (03) :372-380
[6]  
Lantz H, 2003, AM J GASTROENTEROL, V98, P1647
[7]   Optimal conditions for successful ablation of high-grade dysplasia in Barrett's oesophagus using aminolaevulinic acid photodynamic therapy [J].
Mackenzie, Gary D. ;
Dunn, Jason M. ;
Selvasekar, C. R. ;
Mosse, C. Alexander ;
Thorpe, Sally M. ;
Novelli, Marco R. ;
Bown, Stephen G. ;
Lovat, Laurence B. .
LASERS IN MEDICAL SCIENCE, 2009, 24 (05) :729-734
[8]   Five-year efficacy and safety of photodynamic therapy with Photofrin in Barrett's high-grade dysplasia [J].
Overholt, Bergein F. ;
Wang, Kenneth K. ;
Burdick, J. Steven ;
Lightdale, Charles J. ;
Kimmey, Michael ;
Nava, Hector R. ;
Sivak, Michael V., Jr. ;
Nishioka, Norman ;
Barr, Hugh ;
Marcon, Norman ;
Pedrosa, Marcos ;
Bronner, Mary P. ;
Grace, Michael ;
Depot, Michelle .
GASTROINTESTINAL ENDOSCOPY, 2007, 66 (03) :460-468
[9]   Photodynamic therapy with porfimer sodium for ablation of high-grade dysplasia in Barrett's esophagus: international, partially blinded, randomized phase III trial [J].
Overholt, BF ;
Lightdale, CJ ;
Wang, KK ;
Canto, MI ;
Burdick, S ;
Haggitt, RC ;
Bronner, MP ;
Taylor, SL ;
Grace, MGA ;
Depot, M .
GASTROINTESTINAL ENDOSCOPY, 2005, 62 (04) :488-498
[10]  
Shaheen NJ, 2010, GASTROENTEROLOGY, V138, pS16