[Photodynamic therapy effectiveness, safety and cost-effectiveness in oesophagus cancer and Barrett oesophagus treatment]

Sanchez Gomez A, Reza Goyanes M, Callejo Velasco D, Blasco Amaro JA
Record ID 32011001565
Authors' objectives:

Carcinoma of the oesophagus is one of the most aggressive of all cancers and has one of the poorest prognoses. Barrett's oesophagus (BO), the management of which remains controversial, is the precursor condition to oesophageal adenocarcinoma. A number of endoscopic treatments have been designed as an alternative to surgical resection for patients with these diseases. One of these, photodynamic therapy (PDT), involves the light activation of a photosensitizer that causes local tissue destruction via oxidation reactions. The photosensitizer which is selectively absorbed in higher concentrations by the tumour than by the surrounding tissue. Later the photosensitizer is activated through the irradiation of the tumour with laser light of a determined wavelength; this leads to the destruction of the tissue. The present work reviews the effectiveness, safety and cost-effectiveness of photodynamic therapy in oesophagus cancer and barrett oesophagus treatment.

Authors' recommendations: PDT is effective for the ablation of dysplasia in BO. The procedure is presented as a cost-effective alternative to intense endoscopic monitoring and oesophagectomy. However, the evidence regarding its effectiveness in reducing the number of patients who go on to develop cancer is only incipient. Evidence was found suggesting photodynamic therapy to be effective in the ablation of early oesophageal tumours and in the improvement of dysphagia in patients with advanced disease. However the adverse events associated with the use of photodynamic therapy technology are common and can be serious.Rigorous, controlled studies with longer follow-up times, in which PDT is compared to surgical resection and other endoscopic techniques, are needed.
Project Status: Completed
Year Published: 2009
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Spain
MeSH Terms
  • Barrett Esophagus
  • Cost-Benefit Analysis
  • Photochemotherapy
Organisation Name: Unidad de Evaluacion de Tecnologias Sanitarias
Contact Address: Elena Andradas Aragones, Unidad de Evaluacion de Tecnologias Sanitarias, Agencia Lain Entralgo, C/ Gran Via, 27, 8a, ES-28013 Madrid, Spain. Tel: +34 91 3089418; Fax: +34 91 3089458;
Contact Name: elena.andradas@salud.madrid.org
Contact Email: elena.andradas@salud.madrid.org
Copyright: <p>Unidad de Evaluacion de Tecnologias Sanitarias (UETS)</p>
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