PHOTODYNAMIC THERAPY IN BARRETTS-ESOPHAGUS - REDUCTION OF SPECIALIZED MUCOSA, ABLATION OF DYSPLASIA, AND TREATMENT OF SUPERFICIAL ESOPHAGEAL CANCER

被引:31
作者
OVERHOLT, BF [1 ]
PANJEHPOUR, M [1 ]
机构
[1] THOMPSON CANC SURVIVAL CTR,CTR LASER,KNOXVILLE,TN
来源
SEMINARS IN SURGICAL ONCOLOGY | 1995年 / 11卷 / 05期
关键词
ACID INHIBITION; CENTERING BALLOON; PHOTODYNAMIC THERAPY;
D O I
10.1002/ssu.2980110508
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Twelve patients with Barrett's esophagus and dysplasia were treated with photodynamic therapy. Five patients also had early, superficial esophageal cancers and five had esophageal polyps. Light was delivered via a standard diffuser or a centering esophageal balloon. Patients were maintained on omeprazole and followed for 6-54 months. In patients with Barrett's esophagus, photodynamic therapy ablated dysplastic mucosa and malignant mucosa in patients with superficial cancer. Healing and partial replacement of Barrett's mucosa with normal squamous epithelium occurred in all patients and complete replacement with squamous epithelium was found in three patients. Side effects included photosensitivity and mild-moderate chest pain and dysphagia for 5-7 days. In four patients with extensive circumferential mucosal ablation in the mid or proximal esophagus, healing was associated with esophageal strictures which were treated successfully by esophageal dilation. Strictures were not found in the distal esophagus. Photodynamic therapy combined with long-term acid inhibition provides effective endoscopic therapy of Barrett's mucosal dysplasia and superficial (Tis-T1) esophageal cancer. The windowed centering balloon improves delivery of photodynamic therapy to diffusely abnormal esophageal mucosa. (C) 1995 Wiley-Liss, Inc.
引用
收藏
页码:372 / 376
页数:5
相关论文
共 44 条
  • [1] Barrett N, Chronic peptic ulcer of the oesophagus and eso‐phagitis, Br J Surg, 38, pp. 175-182, (1950)
  • [2] Allison PR, Johnstone AS, The oesophagus lined with gastric mucous membrane, Thorax, 8, pp. 87-101, (1953)
  • [3] Cameron AJ, Ott BJ, Payne WS, The incidence of adenocarci‐noma in columnarlined (Barrett's) esophagus, N Engl J Med, 313, pp. 857-859, (1985)
  • [4] Spechler SJ, Robbins AH, Rubins HB, Et al., Adenocarcinoma and Barrett's esophagus. An overrated risk, Gastroenterology, 87, pp. 927-933, (1984)
  • [5] Spechler SJ, Goyal RK, Barrett's esophagus, N Engl J Med, 315, pp. 362-371, (1987)
  • [6] Sprung DJ, Ellis FH, Gibb SP, Incidence of adenocarcinoma in Barrett's esophagus, Am J Gastroenterol, 79, A, (1984)
  • [7] Sjogren RW, Johnson LF, Barrett's esophagus: A review, Am J Med, 74, pp. 313-321, (1983)
  • [8] Haggitt RC, Dean PJ, Adenocarcinoma in Barrett's epithelium, Barrett's Esophagus: Pathophysiology, Diagnosis, and Management, (1985)
  • [9] Naef AP, Savar M, Ozzello L, Columnar‐lined lower esophagus: An acquired lesion with malignant predisposition, J Thorac Cardiovasc Surg, 70, pp. 826-835, (1975)
  • [10] Hamilton SR, Smith RRL, The relationship between columnar epithelial dysplasia and invasive adenocarcinoma arising in Barrett's esophagus, Am J Clin Pathol, 87, (1987)