Eradication of dysplastic Barrett's oesophagus using photodynamic therapy: long-term follow-up

Endoscopy. 2003 Jun;35(6):496-501. doi: 10.1055/s-2003-39676.


Background and study aims: Barrett's oesophagus is a major risk factor for oesophageal adenocarcinoma, a condition which is rapidly increasing in incidence. Photodynamic therapy (PDT) is a developing treatment in which tissue damage is caused by the action of light on a previously administered photosensitizing agent. We present the results of long-term follow-up of its efficacy in patients with dysplastic Barrett's oesophagus.

Patients and methods: A total of 40 patients with low-grade dysplasia in Barrett's oesophagus were treated with oral 5-aminolaevulinic acid (ALA) at a dose of 30 mg/kg, followed by laser endoscopy 4 hours later. Patients were treated between December 1995 and December 1998, and all were followed up regularly with endoscopy and biopsies in our surveillance programme.

Results: Among the patients, 35 (88%) showed a macroscopic reduction in the area of the columnar epithelium, and in all 40 patients dysplasia was found to be eradicated at 1 month. The effect has been maintained for a median follow-up of 53 months (range 18-68 months), although one patient developed a late carcinoma in an untreated area of Barrett's oesophagus 3 years after the intervention.

Conclusions: Safe and effective ablation of low-grade dysplastic Barrett's oesophagus can be achieved with the use of ALA-induced PDT, and the effects are maintained in the long term.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aminolevulinic Acid / therapeutic use*
  • Anti-Ulcer Agents / therapeutic use
  • Barrett Esophagus / drug therapy*
  • Barrett Esophagus / pathology
  • Esophagoscopy
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Omeprazole / therapeutic use
  • Photochemotherapy*
  • Photosensitizing Agents / therapeutic use*
  • Time Factors


  • Anti-Ulcer Agents
  • Photosensitizing Agents
  • Aminolevulinic Acid
  • Omeprazole