Burn, freeze, or photo-ablate?: comparative symptom profile in Barrett's dysplasia patients undergoing endoscopic ablation

Kanwar Rupinder S. Gill; Seth A. Gross; Bruce D. Greenwald; Lois L. Hemminger; Herbert C. Wolfsen

doi:10.1117/12.822827

13 July 2009 Burn, freeze, or photo-ablate?: comparative symptom profile in Barrett's dysplasia patients undergoing endoscopic ablation

Kanwar Rupinder S. Gill, Seth A. Gross, Bruce D. Greenwald, Lois L. Hemminger, Herbert C. Wolfsen

Author Affiliations +

Proceedings Volume 7380, Photodynamic Therapy: Back to the Future; 73804J (2009) https://doi.org/10.1117/12.822827
Event: 12th World Congress of the International Photodynamic Association, 2009, Seattle, Washington, United States

Abstract

Background: There are few data available comparing endoscopic ablation methods for Barrett's esophagus with high-grade dysplasia (BE-HGD). Objective: To determine differences in symptoms and complications associated with endoscopic ablation. Design: Prospective observational study. Setting: Two tertiary care centers in USA. Patients: Consecutive patients with BE-HGD Interventions: In this pilot study, symptoms profile data were collected for BE-HGD patients among 3 endoscopic ablation methods: porfimer sodium photodynamic therapy, radiofrequency ablation and low-pressure liquid nitrogen spray cryotherapy. Main Outcome Measurements: Symptom profiles and complications from the procedures were assessed 1-8 weeks after treatment. Results: Ten BE-HGD patients were treated with each ablation modality (30 patients total; 25 men, median age: 69 years (range 53-81). All procedures were performed in the clinic setting and none required subsequent hospitalization. The most common symptoms among all therapies were chest pain, dysphagia and odynophagia. More patients (n=8) in the porfimer sodium photodynamic therapy group reported weight loss compared to radio-frequency ablactation (n=2) and cryotherapy (n=0). Four patients in the porfimer sodium photodynamic therapy group developed phototoxicity requiring medical treatment. Strictures, each requiring a single dilation, were found in radiofrequency ablactation (n=1) and porfimer sodium photodynamic therapy (n=2) patients. Limitations: Small sample size, non-randomized study. Conclusions: These three endoscopic therapies are associated with different types and severity of post-ablation symptoms and complications.

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Kanwar Rupinder S. Gill, Seth A. Gross, Bruce D. Greenwald, Lois L. Hemminger, and Herbert C. Wolfsen "Burn, freeze, or photo-ablate?: comparative symptom profile in Barrett's dysplasia patients undergoing endoscopic ablation", Proc. SPIE 7380, Photodynamic Therapy: Back to the Future, 73804J (13 July 2009); https://doi.org/10.1117/12.822827

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KEYWORDS

Endoscopy

Radiofrequency ablation

Photodynamic therapy

Therapeutics

Sodium

Chest

Esophagus

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