Barrett's esophagus is the major risk factor for esophageal adenocarcinoma.
5-Aminlevulinic acid-induced photodynamic therapy and argon plasma coagulation have been shown to be effective for ablating Barrett's esophagus, but a comparative trial of these two modalities has not been reported.
Dr Kelty and colleagues from Sheffield, England undertook a study in order to compare photodynamic therapy and argon plasma coagulation for the ablation of Barrett's esophagus.
The researchers recruited a total of 68 patients (54 male, 14 female; median age 61) with Barrett's esophagus for the study.
The research team then randomized participants into groups receiving photodynamic therapy (n = 34) or argon plasma coagulation (n = 34).
Investigators performed photodynamic therapy using 5-aminlevulinic acid (30 mg/kg) and red light.
| Argon plasma coagulation group ablated 97% compared with 50% in the photodynamic therapy group|
|Alimentary Pharmacology and Therapeutics|
Argon plasma coagulation was administered at a power setting of 65 W.
The researchers oversaw multiple treatment sessions with follow-up to 24 months.
All patients showed a macroscopic reduction in the area of Barrett's esophagus.
The researchers found that this was greatest in the argon plasma coagulation group with 97% ablated, compared with 50% in the photodynamic therapy group.
In the remainder, the research team noted that there was a reduction in the length of Barrett's esophagus.
The researchers found buried glands in 24% of photodynamic therapy patients, and in 21% of argon plasma coagulation patients.
Dr Kelty concluded, "Photodynamic therapy and argon plasma coagulation are both effective for ablating Barrett's esophagus."
"Argon plasma coagulation appears more effective than photodynamic therapy, but the impact of both on carcinoma development requires larger studies with long-term follow-up."