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首页> 外文期刊>Photodiagnosis and Photodynamic Therapy >Long term efficacy of Photodynamic Therapy (PDT) as an ablative therapy of high grade dysplasia in Barrett's oesophagus
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Long term efficacy of Photodynamic Therapy (PDT) as an ablative therapy of high grade dysplasia in Barrett's oesophagus

机译：光动力疗法（PDT）作为巴雷特食管高度不典型增生的消融治疗的长期疗效

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Background: Barrett's high grade dysplasia (HGD) is a pre-malignant condition which requires treatment with either oesophagectomy or ablative endoscopic therapy. Endoscopic ablative techniques have evolved through Photodynamic Therapy (PDT) to more recently radiofrequency ablation (RFA). Although RFA has superseded PDT due to improved efficacy and safety profile there remains a significant cohort of patients previously treated by PDT where the long term outcome is unclear. This study's aim was to assess the long term efficacy of PDT in patients with Barrett's HGD. Methods: Between June 2002 and 2007 21 patients (16 male, median age 70) underwent PDT for HGD in Barrett's oesophagus. Patients received intravenous photosensitiser Photofrin (Porfimer sodium) forty eight hours prior to endoscopic light activation by laser light at 630nm. The patients returned at 6-12 weekly intervals for repeat endoscopy and biopsy. Results: Sixteen patients remained free of HGD at median 62 (range 36-114) months. Three patients developed adenocarcinoma at 47, 48 and 54 months (15%). Two patients were treated endoscopically with RFA and YAG laser, while one patient had surgical resection. Four patients developed recurrent HGD treated with repeat PDT. There was a significant reduction in length of Barrett's segment (from 5 cm to 3 cm) post PDT. The stricture rate requiring endoscopic therapy was 37% and 10% of patients developed photosensitivity reactions. Conclusion: PDT successfully ablated HGD in 84% of patients and could therefore still be considered an effective salvage treatment for this condition in patients with co-morbidities precluding them for surgical resection.
机译：背景：巴雷特的高度不典型增生（HGD）是一种恶性前病，需要通过食管切除术或消融内镜治疗进行治疗。内窥镜消融技术已经通过光动力疗法（PDT）演变为最近的射频消融（RFA）。尽管由于疗效和安全性得到改善，RFA取代了PDT，但仍存在大量以前接受PDT治疗的患者，其长期结果尚不清楚。这项研究的目的是评估PDT在Barrett HGD患者中的长期疗效。方法：在2002年6月至2007年之间，对21例患者（男16例，中位年龄70岁）进行了Barrett食管中HGD的PDT治疗。患者在630nm的激光内窥镜激活光之前48小时接受静脉内光敏剂Photofrin（Porfimer钠）。患者每隔6-12周返回一次，以重复进行内窥镜检查和活检。结果：在中位62个月（36-114个月）时，有16例患者没有HGD。 3例分别在47、48和54个月发展为腺癌（15％）。 2例患者接受了RFA和YAG激光内窥镜治疗，其中1例接受了手术切除。四名患者发生重复PDT治疗的复发性HGD。 PDT后Barrett的节段长度显着减少（从5 cm减少到3 cm）。需要内窥镜治疗的狭窄率为37％，而10％的患者发生了光敏反应。结论：PDT成功消除了84％的患者的HGD，因此仍可被认为是排除合并症的合并症患者的有效治疗方法。

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