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Photodynamic therapy for Barrett's oesophagus with use of 5-aminolevulinic acid
- Publication date
- 9 December 1999
- Publisher
- Barrett's oesophagus is a premalignant lesion of the oesophagus characterized
by the presence of colunmar epithelium with intestinal metaplasia in the
distal oesophagus. Oesophageal adenocarcinoma (the most rapidly increasing
cancer in the Western world) is thought to originate from Barrett's oesophagus
following a sequence from metaplasia through dysplasia to adenocarcinoma. To
gain insight in the various aspects of Barrett's oesophagus, the state of the art of
its pathophysiology, diagnosis and management is reviewed in Chapter 1, Part
I, the general introduction of the thesis.
Both endoscopic surveillance and oesophageal resection are recommended
for patients with Barrett's oesophagus and high-grade dysplasia. Tins, however,
is still controversial as the mortality and morbidity associated with oesophageal
resection are considered to be high in view of a preneoplastic disease.
Therefore, endoscopic ablation therapies, including photodynamic therapy, have
been experimentally used to treat Barrett's oesophagus. The characteristics of
the various endoscopic ablation therapies and their results are summarized in
Chapter 2.
The studies described in this thesis aim at making 5-aminolevulinic acidmediated
photodynamic therapy clinically applicable for the endoscopic
treatment of Barrett's oesophagus. For a better understanding of the experinlental
chapters, Part I is completed with Chapter 3, outlining the fundamentals of
5-aminolevulic acid-based photodynamic therapy.