Photodynamic therapy<i>vs</i>radiofrequency ablation for Barrett’s dysplasia: Efficacy, safety and cost-comparison

Ertan, Atilla; Zaheer, Irum; Correa, Arlene M.; Thosani, Nirav; Blackmon, Shanda H.

doi:10.3748/wjg.v19.i41.7106

Cited by 48 publications

(30 citation statements)

References 33 publications

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“…The incidence of these complications is also similar to that of RFA [52]. Photosensitivity is common and is unique to patients undergoing PDT.…”

Section: Photodynamic Therapymentioning

confidence: 71%

“…The rates are higher in patients who undergo multiple sessions of PDT, those who have pre-existing strictures and those with longer segments of BE [55]. In a comparison of PDT with RFA, the rate of strictures was much higher in the PDT group than in the RFA group (28.1 vs 4.0%) [52]. Treatments such as oral steroids have not been successful in preventing the development of these strictures, which usually require multiple sessions of endoscopic dilation to treat [57].…”

Section: Photodynamic Therapymentioning

confidence: 82%

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Limitations of endoscopic ablation in Barrett’s esophagus

Kallam

Alsop

Sharma

2014

Expert Review of Gastroenterology & Hepatology

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In the last 5-10 years, endoscopic ablative therapies have been gaining ground as treatment for Barrett's esophagus associated with high-grade dysplasia and early cancer, and they are becoming the most preferred technique over surgery as the standard of care. These therapies are associated with a lower rate of complications and mortality than surgery; studies have found them to be safe, effective and tolerable. Endoscopic ablative therapies are not, however, without their drawbacks. There is a paucity of data on long-term efficacy, and direct comparisons of the different modalities are lacking. Unlike surgery, current data suggest that endoscopic ablation treatments may not be curative in all patients, so patients require ongoing surveillance and acid suppression. Questions remain regarding durability as well as factors promoting recurrence after endoscopic therapy. The authors conducted a systematic review of the literature on ablative therapies in Barrett's esophagus to describe the modalities currently available and to provide an understanding of their limitations.

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“…The incidence of these complications is also similar to that of RFA [52]. Photosensitivity is common and is unique to patients undergoing PDT.…”

Section: Photodynamic Therapymentioning

confidence: 71%

Section: Photodynamic Therapymentioning

confidence: 82%

Limitations of endoscopic ablation in Barrett’s esophagus

Kallam

Alsop

Sharma

2014

Expert Review of Gastroenterology & Hepatology

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“…In a comparative nonrandomized study, RFA had less complications and reduced cost compared with PDT for the treatment of BE-related dysplasia. 47 …”

Section: Cryoablationmentioning

confidence: 97%

Ablative Endoscopic Therapies for Barrett’s-Esophagus-Related Neoplasia

Peter

Mönkemüller

2015

Gastroenterology Clinics of North America

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“…Radiofrequency ablation was also compared with photodynamic therapy (PDT) in a consecutive series of patients with BE [42]. Complete eradication of dysplasia was achieved in 18/33 patients (54.5%) with PDT and in 47/53 patients (88.7%) with RFA ( P = 0.001) [42].…”

Section: Comparative Datamentioning

confidence: 99%

“…Complete eradication of dysplasia was achieved in 18/33 patients (54.5%) with PDT and in 47/53 patients (88.7%) with RFA ( P = 0.001) [42]. Comparing the results, PDT was five times more costly than RFA and one patient in the PDT group had an esophageal perforation, managed with nonsurgical measures, while no perforation was seen with RFA group [42]. …”

Section: Comparative Datamentioning

confidence: 99%

Outcomes of Radiofrequency Ablation for Dysplastic Barrett’s Esophagus: A Comprehensive Review

Luigiano

Iabichino

Eusebi

et al. 2016

Gastroenterology Research and Practice

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Barrett's esophagus is a condition in which the normal squamous lining of the esophagus has been replaced by columnar epithelium containing intestinal metaplasia induced by recurrent mucosal injury related to gastroesophageal reflux disease. Barrett's esophagus is a premalignant condition that can progress through a dysplasia-carcinoma sequence to esophageal adenocarcinoma. Multiple endoscopic ablative techniques have been developed with the goal of eradicating Barrett's esophagus and preventing neoplastic progression to esophageal adenocarcinoma. For patients with high-grade dysplasia or intramucosal neoplasia, radiofrequency ablation with or without endoscopic resection for visible lesions is currently the most effective and safe treatment available. Recent data demonstrate that, in patients with Barrett's esophagus and low-grade dysplasia confirmed by a second pathologist, ablative therapy results in a statistically significant reduction in progression to high-grade dysplasia and esophageal adenocarcinoma. Treatment of dysplastic Barrett's esophagus with radiofrequency ablation results in complete eradication of both dysplasia and of intestinal metaplasia in a high proportion of patients with a low incidence of adverse events. A high proportion of treated patients maintain the neosquamous epithelium after successful treatment without recurrence of intestinal metaplasia. Following successful endoscopic treatment, endoscopic surveillance should be continued to detect any recurrent intestinal metaplasia and/or dysplasia. This paper reviews all relevant publications on the endoscopic management of Barrett's esophagus using radiofrequency ablation.

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Photodynamic therapyvsradiofrequency ablation for Barrett’s dysplasia: Efficacy, safety and cost-comparison

Abstract: In our experience, RFA had higher rate of CR-D without any serious adverse events and was less costly than PDT for endoscopic treatment of BD.

Cited by 48 publications

References 33 publications

Limitations of endoscopic ablation in Barrett’s esophagus

Limitations of endoscopic ablation in Barrett’s esophagus

Ablative Endoscopic Therapies for Barrett’s-Esophagus-Related Neoplasia

Outcomes of Radiofrequency Ablation for Dysplastic Barrett’s Esophagus: A Comprehensive Review

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