Wang K K, Lutzke L, Borkenhagen L, Westra W, Song M W K, Prasad G, Buttar N S
Mayo Clinic and Foundation, Mayo College of Medicine, Rochester, Minnesota 55905, USA.
Endoscopy. 2008 Dec;40(12):1021-5. doi: 10.1055/s-0028-1103405. Epub 2008 Dec 8.
Photodynamic therapy was the first treatment to have been shown to significantly decrease high-grade dysplasia and cancer in patients with Barrett's esophagus. However, its use has been limited, primarily because of the side effects, which include esophageal strictures, cutaneous photosensitivity, chest pain, and nausea and vomiting. The tolerability aspects of photodynamic therapy, as well as the dosimetry, though, can be improved with existing technologies to further develop this therapy into truly a widely applicable therapy. Studies have recently been done to help identify patients more likely to suffer stricture after photodynamic therapy. In addition there has been evidence to suggest that the efficacy of photodynamic therapy also can be limited by genetic abnormalities in the mucosa. By combining knowledge of tissue biology, optical properties of the tissue, and dosimetry issues with ablation, photodynamic therapy can still have a potentially bright future.
光动力疗法是首个被证实能显著降低巴雷特食管患者高级别异型增生和癌症发生率的治疗方法。然而，其应用一直受到限制，主要原因是副作用，包括食管狭窄、皮肤光敏反应、胸痛以及恶心和呕吐。不过，光动力疗法的耐受性以及剂量测定方面，可通过现有技术加以改进，从而将该疗法进一步发展成为真正广泛适用的疗法。最近已开展研究，以帮助识别光动力疗法后更易发生狭窄的患者。此外，有证据表明，光动力疗法的疗效也可能受到黏膜基因异常的限制。通过将组织生物学知识、组织光学特性以及消融剂量测定问题相结合，光动力疗法仍可能拥有光明的未来。
