Overholt B F, Panjehpour M
Laser Center, Thompson Cancer Survival Center, Knoxville, Tennessee, USA.
Semin Surg Oncol. 1995 Sep-Oct;11(5):372-6. doi: 10.1002/ssu.2980110508.
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.
12例患有巴雷特食管和发育异常的患者接受了光动力疗法治疗。其中5例患者还患有早期浅表食管癌，5例患有食管息肉。通过标准扩散器或中心定位食管球囊进行光照。患者持续服用奥美拉唑，并随访6至54个月。在患有巴雷特食管的患者中，光动力疗法可消融发育异常的黏膜以及浅表癌患者的恶性黏膜。所有患者的巴雷特黏膜均出现愈合，且部分被正常鳞状上皮替代，3例患者的巴雷特黏膜完全被鳞状上皮替代。副作用包括光敏感以及5至7天的轻至中度胸痛和吞咽困难。4例在食管中、上段有广泛周向黏膜消融的患者，愈合过程中出现了食管狭窄，通过食管扩张成功治疗。食管下段未发现狭窄。光动力疗法联合长期抑酸为巴雷特黏膜发育异常和浅表（Tis-T1）食管癌提供了有效的内镜治疗方法。带窗口的中心定位球囊可改善光动力疗法对弥漫性异常食管黏膜的照射效果。
