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01-04-2008 | Original Article

How light dosimetry influences the efficacy of photodynamic therapy with 5-aminolaevulinic acid for ablation of high-grade dysplasia in Barrett’s esophagus

Authors: Gary D. Mackenzie, Neil F. Jamieson, Marco R. Novelli, C. Alexander Mosse, Benjamin R. Clark, Sally M. Thorpe, Stephen G. Bown, Laurence B. Lovat

Published in: Lasers in Medical Science | Issue 2/2008

Abstract

Photodynamic therapy (PDT) with 5-aminolaevulinic acid (ALA) is a novel treatment for high-grade dysplasia (HGD) in Barrett’s esophagus (BE). Our aim was to evaluate the effectiveness of differing light doses. Patients with HGD in BE received oral ALA (60 mg/kg) activated by low (500 J/cm), medium (750 J/cm), high (1,000 J/cm), or highest (1,000 J/cm ×2) light dose at 635 nm. Follow-up was by regular endoscopy with quadrantic biopsies. Twenty-four patients were treated. Successful eradication of HGD was significantly correlated with light dose (log rank, p < 0.01). Six of eight patients (75%) treated with the highest light dose, one of two treated with high dose (50%), two of nine (22%) receiving medium light dose, and zero of five receiving low light dose had successful eradication of HGD (median follow-up 45 months, range 1–78 months). No skin photosensitivity or esophageal strictures occurred. The efficacy of ALA-PDT for eradication of HGD in BE is closely related to the light dose used. With a drug dose of 60 mg/kg and light at 635 nm, we recommend a minimum light dose of 1,000 J/cm of esophagus. This dose appears safe.

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Title: How light dosimetry influences the efficacy of photodynamic therapy with 5-aminolaevulinic acid for ablation of high-grade dysplasia in Barrett’s esophagus
Authors: Gary D. Mackenzie
Neil F. Jamieson
Marco R. Novelli
C. Alexander Mosse
Benjamin R. Clark
Sally M. Thorpe
Stephen G. Bown
Laurence B. Lovat
Publication date: 01-04-2008
Publisher: Springer-Verlag
Published in: Lasers in Medical Science / Issue 2/2008
Print ISSN: 0268-8921
Electronic ISSN: 1435-604X
DOI: https://doi.org/10.1007/s10103-007-0473-7

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How light dosimetry influences the efficacy of photodynamic therapy with 5-aminolaevulinic acid for ablation of high-grade dysplasia in Barrett’s esophagus

Abstract

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Abstract

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