5-Aminolevulinic acid photodynamic therapy versus argon plasma coagulation for ablation of Barrett's oesophagus: a randomised trial

5-Aminolevulinic acid photodynamic therapy versus argon plasma coagulation for ablation of Barrett's oesophagus: a randomised trial
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DOI:
10.1136/gut.2003.028860
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发表时间:
2004-06-01
期刊:
GUT
影响因子:
24.5
通讯作者:
Kuipers, EJ
Kuipers, EJ
中科院分区:
医学1区
文献类型:
--
作者:
Hage, M;Siersema, PD;Kuipers, EJ

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背景:Barrett‘s食道(BO)的消融方法有光化学和热学两种方法。本研究的目的是比较5-氨基乙酰丙酸诱导的光动力疗法(ALA-PDT)和氩离子凝固术(APC)在完全逆转BOB方面的作用。方法:BO患者(32例无不典型增生和8例轻度不典型增生)随机分为三组:(A)ALA-PDT单次剂量100J/cm(2),4小时后(PDT100;n=13);(B)ALA-PDT(分次剂量分别为20和100 J/cm(2),1小时和4小时(PDT20+100;n=13);或(C)功率设置为65W的APC,分两次进行(APC;n=14)。结果:6周时,PDT100组BO平均减少51%(20-100%),PDT20+100组减少86%(0-100%),APC组减少93%(40-100%,P<0.05)。
Background: Photochemical and thermal methods are used for ablating Barrett's oesophagus (BO). The aim of this study was to compare 5-aminolevulinic acid induced photodynamic therapy (ALA-PDT) with argon plasma coagulation (APC) with respect to complete reversal of BO.Methods: Patients with BO (32 no dysplasia and eight low grade dysplasia) were randomised to one of three treatments: (a) ALA-PDT as a single dose of 100 J/cm(2) at four hours (PDT100; n = 13); (b) ALA-PDT as a fractionated dose of 20 and 100 J/cm(2) at one and four hours, respectively (PDT20+ 100; n = 13); or ( c) APC at a power setting of 65 W in two sessions (APC; n = 14). If complete elimination of BO was not achieved by the designated treatment, the remaining BO was treated by a maximum of two sessions of APC.Results: Mean endoscopic reduction of BO at six weeks was 51% (range 20-100%) in the PDT100 group, 86% (range 0-100%) in the PDT20+ 100 group, and 93% (range 40-100%) in the APC group (PDT100 v PDT20+ 100, p