Background: Photodynamic therapy (PDT) with 5-aminolevulinic acid (ALA) has proven to be safe and effective in patients with early neoplasia in Barrett's esophagus. However, long-term results in patients with high-grade intraepithelial neoplasia (HGIN) or with early cancer are still lacking.
Methods: The aim of the study was to evaluate the efficacy of ALA-PDT and the survival of patients with early Barrett's neoplasia. ALA-PDT was carried out in 66 patients. Protoporphyrin IX induced by oral administration of ALA (60 mg/kg body weight orally applied 4-6 hours before PDT) was used as the photosensitizer. Acid suppression was maintained in all patients.
Results: Between September 1996 and September 2002, 667 patients with early neoplasia in Barrett's esophagus were referred for local endoscopic therapy. A total of 558 patients fulfilled the criteria for local endoscopic therapy, and 66 patients (mean [standard deviation] age 61.4 [10.2] years) with HGIN (group A; n = 35) and early adenocarcinoma (group B; n = 31) were treated by PDT. A total of 82 ALA-PDT were performed. A total of 34 of the 35 patients in group A (97%) and all patients in group B (100%) achieved a complete response during a median follow-up period of 37 months (interquartile range 23-55) (not significant). One local recurrence was observed in group A and 10 in group B (p < 0.005). Seven patients died during follow-up; but, all deaths were not tumor related. No major complications were observed. Disease-free survival in patients with HGIN was 89%, and, in patients with mucosal cancer, it was 68%. The calculated 5-year survival was 97% in group A and 80% in group B, but there occurred no death related to Barrett's neoplasia.
Conclusions: The excellent long-term results of PDT with ALA in patients with HGIN or mucosal cancer might offer PDT with ALA as an alternative to surgical esophagectomy and endoscopic resection, especially in cases with multifocal Barrett's neoplasia.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/s0016-5107(05)00333-0 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Single-cell profiling reveals the intratumor heterogeneity and immunosuppressive microenvironment in cervical adenocarcinoma.
Elife
March 2025
Department of Pathology, Third Hospital, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China.
Background: Cervical adenocarcinoma (ADC) is more aggressive compared to other types of cervical cancer (CC), such as squamous cell carcinoma (SCC). The tumor immune microenvironment (TIME) and tumor heterogeneity are recognized as pivotal factors in cancer progression and therapy. However, the disparities in TIME and heterogeneity between ADC and SCC are poorly understood.
View Article and Find Full Text PDFTraining and assessment of skills in flexible optical intubation - Protocol of a scoping review.
Acta Anaesthesiol Scand
April 2025
Department of Anaesthesiology and Intensive Care, Lillebaelt University Hospital, Kolding, Denmark.
Background: Flexible optical intubation (FOI) is the preferred technique for managing anticipated difficult airways, particularly in awake patients when anatomical factors complicate conventional laryngoscopy. Mastering the procedure requires skills, but a comprehensive overview of the evidence on training and assessment of FOI skills is lacking. There is no evidence-based consensus on educational strategies and recommendations for skill acquisition and retention, thus highlighting a significant gap in airway management training.
View Article and Find Full Text PDFEffects of immersive virtual reality-based action observation training integrated with focal muscle vibration on upper extremity in a patient with chronic disability following stroke: a single-subject study.
Physiother Theory Pract
March 2025
Physiotherapy Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
Background: The association of different sensory inputs enhances brain plasticity in patients after stroke, but no studies have associated Action Observation Training (AOT) delivered in immersive virtual reality (VR) with Focal Vibration (FV) to elicit a kinesthetic illusion coherent with the observed task to improve motor function.
Objective: The study aimed to evaluate the feasibility of AOT delivered in immersive VR integrated with FV of upper limb muscles on manual dexterity in patients with chronic stroke.
Methods: A single-subject study was conducted (A-B design).
Factors influencing vaccine hesitancy among United Kingdom adolescents in a senior high school environment and actions to address it.
Hum Vaccin Immunother
December 2025
Sixth Form Department, Townley Grammar School, Bexleyheath, UK.
We explored adolescent viewpoints on vaccines and hesitancy using an anonymized, validated, self-completed electronic questionnaire amongst state-school Year 12-13 adolescents in London, UK. As the response rate was low (Cohort 1; = 112/486, 23.0%), we repeated the survey with incoming students (cohort 2, = 256/275; 93%).
View Article and Find Full Text PDFNeonatal lupus erythematosus: an acquired autoimmune disease to be taken seriously.
Ann Med
December 2025
Department of Neonatology, Children's Hospital of Soochow University, Suzhou, China.
Aim: This review aims to summarize the epidemiology, pathogenesis, clinical features, management, prognosis and regression of Neonatal lupus erythematosus (NLE) with a view to providing directions for standardized diagnosis, treatment and further research.
Methods: We conducted a comprehensive literature review of NLE. NLE-related peer-reviewed papers were searched through PubMed/Medline were searched up to November 2024.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!