Subscribe to RSS
DOI: 10.1055/s-2003-44604
Photodynamic Therapy for Esophageal Diseases: A Clinical Update
Publication History
Submitted 26 June 2003
Accepted after Revision 9 July 2003
Publication Date:
27 November 2003 (online)
Photodynamic therapy (PDT) is a ”drug and device” therapy that combines the use of a photosensitizing agent and a photosensitizer (a drug that selectively accumulates and is preferentially retained in dysplastic or neoplastic cells). When activated by light of a specific wavelength in the presence of oxygen, the photoactive compound produces rapid cell death in the target tissue. While studied in nearly every area of medicine, PDT has been applied most extensively in the treatment of Barrett’s mucosa, dysplasia, and early and advanced cancer of the esophagus. This article represents an extensive survey of literature to review the experience gained with PDT and to assess its clinical value in the management of esophageal diseases.
References
- 1 Oleinick N L, Evans H H. The photobiology of photodynamic therapy: cellular targets and mechanisms. Radiat Res. 1998; 150 s146-s156
- 2 Wang K K. Current status of photodynamic therapy of Barrett’s esophagus. Gastrointest Endosc. 1999; 49 S20-S23
- 3 Dougherty T J. An update on photodynamic therapy applications. J Clin Laser Med Surg. 2002; 20 3-7
- 4 Conio M, Lapertosa G, Blanchi S. et al . Barrett’s esophagus: an update. Crit Rev Oncol Hematol. 2003; 46 187-206
- 5 Koop H. Gastroesophageal reflux disease and Barrett’s esophagus. Endoscopy. 2002; 34 97-103
- 6 Rosch T. Gastroesophageal reflux disease and Barrett’s esophagus. Endoscopy. 2001; 33 909-916
- 7 Birkmeyer J D, Siewers A E, Finlayson E V. et al . Hospital volume and surgical mortality in the United States. N Engl J Med. 2002; 346 1128-1137
- 8 Ortner M A, Dorta G, Blum A L. et al . Endoscopic interventions for preneoplastic and neoplastic lesions: mucosectomy, argon plasma coagulation, and photodynamic therapy. Dig Dis. 2002; 20 167-172
- 9 Leiper K, Morris A I. Treatment of oesophagogastric tumours. Endoscopy. 2002; 34 139-145
- 10 Kahaleh M, van Laethem J L, Nagy N. et al . Long-term follow-up and factors predictive of recurrence in Barrett’s esophagus treated by argon plasma coagulation and acid suppression. Endoscopy. 2002; 34 950-955
- 11 van Laethem J L, Jagodzinski R, Peny M O. et al . Argon plasma coagulation in the treatment of Barrett’s high-grade dysplasia and in situ adenocarcinoma. Endoscopy. 2001; 33 257-261
- 12 Enns R A. Prospective randomized trial of argon plasma coagulation versus multipolar electrocoagulation in the ablation of Barrett’s esophagus without dysplasia: preliminary results. Gastroenterology. 2002; 122 A685
- 13 Wolfsen H C. Photodynamic therapy for mucosal esophageal adenocarcinoma and dysplastic Barrett’s esophagus. Dig Dis. 2002; 20 5-17
- 14 Marcon N E. Photodynamic therapy and cancer of the esophagus. Semin Oncol. 1994; 21 20-23
- 15 Bown S G, Rogowska A Z. New photosensitizers for photodynamic therapy in gastroenterology. Can J Gastroenterol. 1999; 13 389-392
- 16 Overholt B F, Panjehpour M, Haydek J M. Photodynamic therapy for Barrett’s esophagus: follow-up in 100 patients. Gastrointest Endosc. 1999; 49 1-7
- 17 Wolfsen H C, Woodward T A, Raimondo M. Photodynamic therapy for dysplastic Barrett esophagus and early esophageal adenocarcinoma. Mayo Clin Proc. 2002; 77 1176-1181
- 18 Panjehpour M, Overholt B F, Haydek J M. et al . Results of photodynamic therapy for ablation of dysplasia and early cancer in Barrett’s esophagus and effect of oral steroids on stricture formation. Am J Gastroenterol. 2000; 95 2177-2184
- 19 Gossner L, Stolte M, Sroka R. et al . Photodynamic ablation of high-grade dysplasia and early cancer in Barrett’s esophagus by means of 5-aminolevulinic acid. Gastroenterology. 1998; 114 448-455
- 20 Gossner L, May A, Sroka R. et al . Photodynamic destruction of high grade dysplasia and early carcinoma of the esophagus after the oral administration of 5-aminolevulinic acid. Cancer. 1999; 86 1921-1928
- 21 Gossner L, May A, Sroka R. et al . A new long-range through-the-scope balloon applicator for photodynamic therapy in the esophagus and cardia. Endoscopy. 1999; 31 370-376
- 22 Javaid B, Watt P, Krasner N. Photodynamic therapy (PDT) for oesophageal dysplasia and early carcinoma with mTHPC (m-tetrahydroxyphenyl chlorin): a preliminary study. Lasers Med Sci. 2002; 17 51-56
- 23 Ackroyd R, Brown N J, Davis M F. et al . Photodynamic therapy for dysplastic Barrett’s oesophagus: a prospective, double blind, randomised, placebo controlled trial. Gut. 2000; 47 612-617
- 24 Ackroyd R, Brown N J, Davis M F. et al . Aminolevulinic acid-induced photodynamic therapy: safe and effective ablation of dysplasia in Barrett’s esophagus. Dis Esoph. 2000; 13 18-22
- 25 Barr H, Shepherd N A, Dix A. et al . Eradication of high-grade dysplasia in columnar-lined (Barrett’s) oesophagus by photodynamic therapy with endogenously generated protoporphyrin IX. Lancet. 1996; 348 584-585
- 26 Orth K, Stanescu A, Ruck A. et al . [Photodynamic ablation and argon-plasma coagulation of premalignant and early-stage malignant lesions of the oesophagus - an alternative to surgery?]. Chirurg. 1999; 70 431-438
- 27 Ortner M A, Zumbusch K, Liebetruth J. et al . Is topical delta-aminolevulinic acid adequate for photodynamic therapy in Barrett’s esophagus? A pilot study. Endoscopy. 2002; 34 611-616
- 28 McCaughan J S, Jr., Ellison E C, Guy J T. et al . Photodynamic therapy for esophageal malignancy: a prospective twelve-year study. Ann Thorac Surg. 1996; 62 1005-1009
- 29 Corti L, Skarlatos J, Boso C. et al . Outcome of patients receiving photodynamic therapy for early esophageal cancer. Int J Radiat Oncol Biol Phys. 2000; 47 419-424
- 30 Gossner L, May A, Pech O. et al . Photodynamic therapy of Barrett’s esophagus with dysplasia or early cancer [abstract]. Gastroenterology. 1999; 116 A413
- 31 Tan W C, Fulljames C, Stone N. et al . Photodynamic therapy using 5-aminolaevulinic acid for oesophageal adenocarcinoma associated with Barrett’s metaplasia. J Photochem Photobiol B. 1999; 53 75-80
- 32 Maier A, Anegg U, Fell B. et al . Hyperbaric oxygen and photodynamic therapy in the treatment of advanced carcinoma of the cardia and the esophagus. Lasers Surg Med. 2000; 26 308-315
- 33 Regula J, MacRobert A J, Gorchein A. et al . Photosensitisation and photodynamic therapy of oesophageal, duodenal, and colorectal tumours using 5 aminolaevulinic acid induced protoporphyrin IX - a pilot study. Gut. 1995; 36 67-75
- 34 Tian M E, Qui S L, Ji Q. Preliminary results of hematoporphyrin derivative-laser treatment for 13 cases of early esophageal carcinoma. Adv Exp Med Biol. 1985; 193 21-25
- 35 Fujimaki M, Nakayama K. Endoscopic laser treatment of superficial esophageal cancer. Semin Surg Oncol. 1986; 2 248-256
- 36 Tajiri H, Daikuzono N, Joffe S N. et al . Photoradiation therapy in early gastrointestinal cancer. Gastrointest Endosc. 1987; 33 88-90
- 37 Hayata Y, Kato H, Konaka C. et al . [Laser endoscopy in photodynamic therapy]. Chirurg. 1988; 59 81-89
- 38 Okunaka T, Kato H, Conaka C. et al . Photodynamic therapy of esophageal carcinoma. Surg Endosc. 1990; 4 150-153
- 39 Grosjean P, Wagnieres G, Fontolliet C. et al . Clinical photodynamic therapy for superficial cancer in the oesophagus and the bronchi: 514 nm compared with 630 nm light irradiation after sensitization with Photofrin II. Br J Cancer. 1998; 77 1989-1995
- 40 Sibille A, Lambert R, Souquet J C. et al . Long-term survival after photodynamic therapy for esophageal cancer. Gastroenterology. 1995; 108 337-344
- 41 Lightdale C J, Heier S K, Marcon N E. et al . Photodynamic therapy with porfimer sodium versus thermal ablation therapy with Nd:YAG laser for palliation of esophageal cancer: a multicenter randomized trial. Gastrointest Endosc. 1995; 42 507-512
- 42 Heier S K, Rothman K A, Heier L M. et al . Photodynamic therapy for obstructing esophageal cancer: light dosimetry and randomized comparison with Nd:YAG laser therapy. Gastroenterology. 1995; 109 63-72
- 43 Jin M, Yang B, Zhang W. et al . Photodynamic therapy for upper gastrointestinal tumours over the past 10 years. Semin Surg Oncol. 1994; 10 111-113
- 44 Luketich J D, Christie N A, Buenaventura P O. et al . Endoscopic photodynamic therapy for obstructing esophageal cancer: 77 cases over a 2-year period. Surg Endosc. 2000; 14 653-657
- 45 Scheider D M, Siemens M, Cirocco M. et al . Photodynamic therapy for the treatment of tumor ingrowth in expandable esophageal stents. Endoscopy. 1997; 29 271-274
- 46 Savary J F, Grosjean P, Monnier P. et al . Photodynamic therapy of early squamous cell carcinomas of the esophagus: a review of 31 cases. Endoscopy. 1998; 30 258-265
- 47 Savary J F, Monnier P, Fontolliet C. et al . Photodynamic therapy for early squamous cell carcinomas of the esophagus, bronchi, and mouth with m-tetra (hydroxyphenyl) chlorin. Arch Otolaryngol Head Neck Surg. 1997; 123 162-168
- 48 Grosjean P, Savary J-F, Wagnieres G. et al . Tetra(m-hydroxyphenyl)chlorin clinical photodynamic therapy of early bronchial and oesophageal cancers. Lasers Med Sci. 1996; 11 227-235
- 49 Mlkvy P, Messmann H, Regula J. et al . Photodynamic therapy for gastrointestinal tumors using three photosensitizers - ALA induced PPIX, Photofrin and MTHPC. A pilot study. Neoplasma. 1998; 45 157-161
- 50 Maier A, Tomaselli F, Matzi V. et al . Photosensitization with hematoporphyrin derivative compared to 5-aminolaevulinic acid for photodynamic therapy of esophageal carcinoma. Ann Thorac Surg. 2001; 72 1136-1140
- 51 Maier A, Tomaselli F, Matzi V. et al . Does new photosensitizer improve photodynamic therapy in advanced esophageal carcinoma?. Lasers Med Sci. 2001; 29 323-327
- 52 van den Bergh H. On the evolution of some endoscopic light delivery systems for photodynamic therapy. Endoscopy. 1998; 30 392-407
- 53 Panjehpour M, Overholt B F, Haydek J M. Light sources and delivery devices for photodynamic therapy in the gastrointestinal tract. Gastrointest Endosc Clin N Am. 2000; 10 513-532
- 54 Overholt B F, Panjehpour M, DeNovo R C. et al . Balloon photodynamic therapy of esophageal cancer: effect of increasing balloon size. Lasers Surg Med. 1996; 18 248-252
- 55 Stepinac T, Grosjean P, Woodtli A. et al . Optimization of the diameter of a radial irradiation device for photodynamic therapy in the esophagus. Endoscopy. 2002; 34 411-415
- 56 Braichotte D R, Savary J F, Monnier P. et al . Optimizing light dosimetry in photodynamic therapy of early stage carcinomas of the esophagus using fluorescence spectroscopy. Lasers Surg Med. 1996; 19 340-346
- 57 Zellweger M, Grosjean P, Monnier P. et al . Stability of the fluorescence measurement of Foscan in the normal human oral cavity as an indicator of its content in early cancers of the esophagus and the bronchi. Photochem Photobiol. 1999; 69 605-610
- 58 Radu A, Conde R, Fontolliet C. et al . Mucosal ablation with photodynamic therapy in the esophagus: optimization of light dosimetry in the sheep model. Gastrointest Endosc. 2003; 57 897-905
- 59 Cheung R, Solonenko M, Busch T M. et al . Correlation of in vivo photosensitizer fluorescence and photodynamic therapy-induced depth of necrosis in a murine tumor model. J Biomed Opt. 2003; 8 248-252
- 60 Overholt B F, Panjehpour M. Photodynamic therapy for Barrett’s esophagus. Gastrointest Endosc Clin N Am. 1997; 7 207-220
- 61 Wolfsen H C, Ng C S. Cutaneous consequences of photodynamic therapy. Cutis. 2002; 69 140-142
- 62 Dolmans D E, Fukumura D, Jain R K. Photodynamic therapy for cancer. Nat Rev Cancer. 2003; 3 380-387
- 63 Inoue H, Tani M, Nagai K. et al . Treatment of esophageal and gastric tumors. Endoscopy. 1999; 31 47-55
- 64 Shim C S. Role of endoscopic ultrasonography for gastric lesions. Endoscopy. 1998; 30 (Suppl 1) A55-A59
- 65 Soetikno R M, Gotoda T, Nakanishi Y. et al . Endoscopic mucosal resection. Gastrointest Endosc. 2003; 57 567-579
- 66 Moreto M. Diagnosis of esophagogastric tumors. Endoscopy. 2003; 35 36-42
- 67 Shim C S. Endoscopic mucosal resection: an overview of the value of different techniques. Endoscopy. 2001; 33 271-275
- 68 Rembacken B J, Gotoda T, Fujii T. et al . Endoscopic mucosal resection. Endoscopy. 2001; 33 709-718
- 69 Nijhawan P K, Wang K K. Endoscopic mucosal resection for lesions with endoscopic features suggestive of malignancy and high-grade dysplasia within Barrett’s esophagus. Gastrointest Endosc. 2000; 52 328-332
- 70 Ell C, May A, Gossner L. et al . Endoscopic mucosal resection of early cancer and high-grade dysplasia in Barrett’s esophagus. Gastroenterology. 2000; 118 670-677
- 71 May A, Gossner L, Pech O. et al . Intraepithelial high-grade neoplasia and early adenocarcinoma in short-segment Barrett’s esophagus (SSBE): curative treatment using local endoscopic treatment techniques. Endoscopy. 2002; 34 604-610
- 72 Al-Kasspooles M F, Hill H C, Nava H R. et al . High-grade dysplasia within Barrett’s esophagus: controversies regarding clinical opinions and approaches. Ann Surg Oncol. 2002; 9 222-227
- 73 Buttar N S, Wang K K, Lutzke L S. et al . Combined endoscopic mucosal resection and photodynamic therapy for esophageal neoplasia within Barrett’s esophagus. Gastrointest Endosc. 2001; 54 682-688
- 74 Montgomery E, Bronner M P, Goldblum J R. et al . Reproducibility of the diagnosis of dysplasia in Barrett esophagus: a reaffirmation. Hum Pathol. 2001; 32 368-378
- 75 Edwards M J, Gable D R, Lentsch A B. et al . The rationale for esophagectomy as the optimal therapy for Barrett’s esophagus with high-grade dysplasia. Ann Surg. 1996; 223 585-589; discussion 9 - 91
- 76 Ferguson M K, Naunheim K S. Resection for Barrett’s mucosa with high-grade dysplasia: implications for prophylactic photodynamic therapy. J Thorac Cardiovasc Surg. 1997; 114 824-829
- 77 Krishnadath K K, Wang K K, Taniguchi K. et al . Persistent genetic abnormalities in Barrett’s esophagus after photodynamic therapy. Gastroenterology. 2000; 119 624-630
- 78 Bourre L, Thibaut S, Briffaud A. et al . Potential efficacy of a delta 5-aminolevulinic acid thermosetting gel formulation for use in photodynamic therapy of lesions of the gastrointestinal tract. Pharmacol Res. 2002; 45 159-165
- 79 Zopf T, Rosenbaum A, Apel D. et al . [Photodynamic therapy of dysplasias and early carcinomas in Barrett esophagus with a diode laser system - a pilot study]. Med Klin. 2001; 96 212-216
- 80 Brand R E. Going all the way?. Am J Gastroenterol. 2000; 95 3032-3033
- 81 Bourg-Heckly G, Blais J, Padilla J J. et al . Endoscopic ultraviolet-induced autofluorescence spectroscopy of the esophagus: tissue characterization and potential for early cancer diagnosis. Endoscopy. 2000; 32 756-765
- 82 Li X D, Boppart S A, Van Dam J. et al . Optical coherence tomography: advanced technology for the endoscopic imaging of Barrett’s esophagus. Endoscopy. 2000; 32 921-930
- 83 Canto M I, Yoshida T, Gossner L. Chromoscopy of intestinal metaplasia in Barrett’s esophagus. Endoscopy. 2002; 34 330-336
- 84 Lambert R. Diagnosis of esophagogastric tumors. Endoscopy. 2002; 34 129-138
- 85 Shim C S. Staining in gastrointestinal endoscopy: clinical applications and limitations. Endoscopy. 1999; 31 487-496
R. L. Prosst,M. D.
Chirurgische Universitätsklinik Mannheim
Theodor-Kutzer-Ufer 1 - 3 · 68167 Mannheim · Germany
Fax: +49-621-383-2109
Email: ruediger@prosst.de