How light dosimetry influences the efficacy of photodynamic therapy with 5-aminolaevulinic acid for ablation of high-grade dysplasia in Barrett’s esophagus

被引：0
作者：
Gary D. Mackenzie
Neil F. Jamieson
Marco R. Novelli
C. Alexander Mosse
Benjamin R. Clark
Sally M. Thorpe
Stephen G. Bown
Laurence B. Lovat
机构：
[1] University College London,National Medical Laser Centre, Department of Surgery, Royal Free and University College Medical School
[2] University College London,Department of Histopathology, Royal Free and University College Medical School
[3] University College London Hospitals NHS Trust,Department of Gastroenterology
来源：
Lasers in Medical Science | 2008年 / 23卷
关键词：
Aminolaevulinic acid; Barrett’s esophagus; Photodynamic therapy; High-grade dysplasia; Cancer;
D O I：
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摘要：
Photodynamic therapy (PDT) with 5-aminolaevulinic acid (ALA) is a novel treatment for high-grade dysplasia (HGD) in Barrett’s esophagus (BE). Our aim was to evaluate the effectiveness of differing light doses. Patients with HGD in BE received oral ALA (60 mg/kg) activated by low (500 J/cm), medium (750 J/cm), high (1,000 J/cm), or highest (1,000 J/cm ×2) light dose at 635 nm. Follow-up was by regular endoscopy with quadrantic biopsies. Twenty-four patients were treated. Successful eradication of HGD was significantly correlated with light dose (log rank, p < 0.01). Six of eight patients (75%) treated with the highest light dose, one of two treated with high dose (50%), two of nine (22%) receiving medium light dose, and zero of five receiving low light dose had successful eradication of HGD (median follow-up 45 months, range 1–78 months). No skin photosensitivity or esophageal strictures occurred. The efficacy of ALA-PDT for eradication of HGD in BE is closely related to the light dose used. With a drug dose of 60 mg/kg and light at 635 nm, we recommend a minimum light dose of 1,000 J/cm of esophagus. This dose appears safe.
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页码：203 / 210
页数：7
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