I assume this is Photofrin:
Photodynamic therapy may worsen esophageal dysmotility
Last Updated: 2001-10-26 13:50:48 EDT (Reuters Health)
WESTPORT, CT (Reuters Health) - Esophageal dysmotility is common in patients with esophageal adenocarcinoma or Barrett esophagus, and photodynamic therapy can worsen it, according to a report in the October issue of Mayo Clinic Proceedings.
In a prospective study, Dr. Herbert C. Wolfsen and colleagues, from the Mayo Clinic in Jacksonville, Florida, examined esophageal motility in 23 such patients before and after photodynamic therapy.
"Esophageal motility testing of the lower esophageal sphincter and esophageal body was performed with a water-perfused catheter, 2 days before and at least 3 weeks after patients underwent photodynamic therapy," the team explains.
Thirteen of the 23 patients had adenocarcinoma and 10 had Barrett esophagus with high-grade dysplasia. Prior to photodynamic therapy, normal motility was observed in 11 patients (48%), ineffective esophageal motility in six (26%), and aperistalsis in six (26%).
Followup tracings showed that six patients (26%) had normal motility, seven (30%) had ineffective esophageal motility, and 10 (43%) had aperistalsis after photodynamic therapy.
"Dysphagia after photodynamic therapy...may be related to underlying esophageal dysmotility and may not always be caused by stricture or underlying carcinoma," Dr. Wolfsen and his colleagues conclude.
"If patients with esophageal cancer are suspected of having aperistalsis, then the preferred method of palliation may be placement of an expandable metal stent and not photodynamic therapy," they point out. "For patients with a previous history of chemoradiation therapy, photodynamic therapy must be used with caution, because of both the high risk of stricture formation and the possible deterioration of esophageal motility."
"Finally, for patients who have undergone apparent successful photoablation of dysplastic Barrett esophagus, possible antireflux surgery must be approached with caution."
Mayo Clin Proc 2001;76:987-989 |
