A team from Rochester, Minnesota, USA, studied the combination of endoscopic mucosal resection (EMR) and photodynamic therapy in the treatment of superficial cancer in patients with Barrett's esophagus.
A total of 17 (15 men, mean age 69 years) consecutive, nonsurgical patients with superficial cancers underwent EMR followed by photodynamic therapy with a porphyrin photosensitizer.
Photoradiation was performed at 630 nm for a total dose of 200 J/cm of diffuser.
The researchers found that mean diameter of mucosal resection was 1 cm. There was evidence of malignancy in the margins of 3 cases.
|EMR and photodynamic therapy:|
- Improved cancer staging
- Removed superficial cancer
- Eliminated at risk mucosa
| Gastrointestinal Endoscopy |
EMR improved staging in 8 patients (47%), and 16 (94%) patients remained in remission after a median follow-up 13 months.
Complications included minor bleeding after EMR in 1 patient (6%), stricture in 5 (30%), cutaneous phototoxicity in 2 (12%), and supraventricular tachycardia in 1 patient (6%).
Dr Navtej S. Buttar, of the Mayo Clinic and Foundation, Rochester, concluded, "Combined EMR and photodynamic therapy appears to be an effective and safe therapy for superficial esophageal cancer within Barrett's esophagus.
"This combination improves cancer staging, removes the superficial cancer, and eliminates remaining mucosa at risk for cancer development."