The potential role for photodynamic therapy in the management of upper gastrointestinal disease
Open accessAbstract
Photodynamic therapy involves the activation of an exogeneously administered, or an endogenously gen‐erated, photosensitizer with light to produce localized tissue destruction. It is an attractive, predominantly endosopic technique for the palliation of advanced upper gastrointestinal cancer and the eradication of early neoplastic and pre‐neoplastic lesions. The nature of the biological response allowing safe healing and the exploitation of tissue threshold effects mean that adjacent tissue damage can be minimized. This review used a database of 368 papers. The nature of the photosensitizer is critical to the depth of tissue damage and the risk of adjacent tissue damage and stricture formation. The generation of protoporphyrin IX following administration of 5‐aminolaevulinic acid has proved useful for the treatment of high‐grade dysplasia in Barrett’s oesophagus. A double‐blind randomized placebo controlled trial has confirmed that it is a safe and effective method for the ablation of low‐grade dysplasia. The treatment of more advanced lesions requires exogeneously administered photo‐sensitizers. However, recent data indicate that the neoplastic potential remains in some patients and continued follow‐up is necessary. Photodynamic therapy can be used to eradicate early neoplasia and palliate advanced cancer, but caution is required before a definitive cure can be claimed.
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Therapies of high-grade dysplasia and metaplasia of Barrett's esophagus rely on preferential uptake of ALA, which is 3.5 times greater in mucosa than in muscles.
“The therapies of high-grade dysplasia and metaplasia of Barrett’s esophagus rely on preferential uptake of ALA, which is 3.5 times greater in mucosa then in muscles [123].”
From Aminolevulinic Acid (ALA) as a Prodrug in Photodynamic Therapy of Cancer (2011) · cites this paper as [123]
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- Authors
- Barr, H., Dix, A. J., Kendall, C., & Stone, N.
- Affiliations
- Gloucestershire Royal Hospital (GB)
- Corresponding author
- Barr, H.
- Venue
- Alimentary Pharmacology & Therapeutics
- Publisher
- Wiley
- Published
- 2001-03-06
- Volume
- 15
- Issue
- 3
- Pages
- 311-321
- ISSN
- 0269-2813 (ISSN-L)
- 1365-2036
- OpenAlex
- W2087249039
- Cited by
- 40
- References
- 79
- Citations by year
- 2024: 1 · 2023: 1 · 2021: 1 · 2020: 1 · 2017: 3 · 2016: 1 · 2015: 2 · 2012: 1
- FWCI
- 1.11
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Alimentary Pharmacology & Therapeutics (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Photodynamic Therapy Research Studies
- Health Sciences › Medicine › Surgery › Esophageal Cancer Research and Treatment
- Physical Sciences › Engineering › Biomedical Engineering › Nanoplatforms for cancer theranostics
- Keywords
- photodynamic therapy, upper gastrointestinal diseases, photosensitizers, 5-aminolevulinic acid, protoporphyrin IX, Barrett's esophagus, high-grade dysplasia, low-grade dysplasia, endoscopic ablation, early neoplasia, stricture formation
- MeSH terms
- Barrett Esophagus, Carcinoma, Squamous Cell, Esophageal Neoplasms, Humans, Palliative Care, Pancreatic Neoplasms, Photochemotherapy, Stomach Neoplasms, Helicobacter Infections, Photosensitizing Agents, Patient Selection
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