Long Term Results of PDT for Early Neoplasia in Barrett's Esophagus

Abstract

Objectives: Photodynamic therapy (PDT) has proved to be save and effective in patients with early neoplasia in Barrett's esophagus. Although there are several reports on PDT in these patients, long term results are still lacking. Methods: Between January 1997 and January 2003, 680 patients with early neoplasia in Barrett's esophagus were referred for local endoscopic therapy. 66 patients (mean age 61.4 ± 10.2 years) with high grade intraepithelial neoplasia (HGIN) (group A; n = 35) and early adenocarcinoma (group B; n = 31) were treated by PDT. Protoporphyrin IX induced by oral administration of 5-aminolevulinic acid was used as photosensitizer. Results: A total of 82 ALA-PDT were performed. 34 of the 35 patients in group A (97%) and all patients in group B (100%) achieved a complete response during a mean follow-up period of 41.7 ± 18.4 months. One local recurrence was observed in group A, and 10 in group B. 7 patients died during follow-up, but no death was tumor-related. No major complications were observed. The calculated 6-year survival was 97% in group A and 75% in group B. Conclusions: The long term results show excellent survival rates in patients with early neoplasia in Barrett's esophagus treated by ALA-PDT.