Photodynamic therapy for dysplastic Barrett's oesophagus: long-term follow-up

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Abstract
Background: Photodynamic therapy (PDT) is a novel treatment in which tissue damage is caused by the action of light on a previously administered photosensitizing agent. The results of long-term follow-up of the use of PDT in patients with dysplastic Barrett's oesophagus are presented. Methods: Thirty-seven patients with low-grade dysplastic Barrett's oesophagus were treated with oral 5-aminolaevulinic acid (ALA) 30 mg kg1, followed by laser endoscopy 4 h later. Patients were treated between December 1995 and December 1998, and all were followed regularly with endoscopy and biopsies in the authors' surveillance programme. Results: All patients initially showed eradication of dysplasia, and 32 of 37 had a macroscopic reduction in the length of columnar epithelium. The effect was maintained for a median of 43 (range 18–54) months, although one patient developed a late carcinoma. Conclusion: ALA-induced PDT can provide safe and effective ablation of low-grade dysplastic Barrett's oesophagus, and the effects appear to be maintained for a protracted period of time.

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