Photodiagnosis and Photodynamic Therapy
Volume 3, Issue 2 , Pages 87-92, June 2006

Bare fiber photodynamic therapy using porfimer sodium for esophageal disease

  • Herbert Wolfsen, MD

      Affiliations

    • Divisions of Gastroenterology and Hepatology, Mayo Clinic, 6A Davis Bldg., 4500 San Pablo Road, Jacksonville, FL 32224, USA
    • Divisions of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD, USA
    • Divisions of Gastroenterology and Hepatology, Ochsner Clinic, New Orleans, LA, USA
    • Divisions of Gastroenterology and Hepatology, University of Maryland, Baltimore, MD, USA
    • Divisions of Gastroenterology and Hepatology, Duke University, Durham, NC, USA
    • Divisions of Gastroenterology and Hepatology, Virginia Mason Medical Center, Seattle, WA, USA
    • Divisions of Gastroenterology and Hepatology, University of California, San Francisco, CA, USA
    • Divisions of Gastroenterology and Hepatology, University of Miami, Miami, FL, USA
    • Divisions of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, AZ, USA
    • Divisions of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, PA, USA
    • Corresponding Author InformationCorresponding author. Tel.: +1 904 953 2221; fax: +1 904 953 7260.
    • ,
  • Marcia Canto

      Affiliations

    • Divisions of Gastroenterology and Hepatology, Mayo Clinic, 6A Davis Bldg., 4500 San Pablo Road, Jacksonville, FL 32224, USA
    • Divisions of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD, USA
    • Divisions of Gastroenterology and Hepatology, Ochsner Clinic, New Orleans, LA, USA
    • Divisions of Gastroenterology and Hepatology, University of Maryland, Baltimore, MD, USA
    • Divisions of Gastroenterology and Hepatology, Duke University, Durham, NC, USA
    • Divisions of Gastroenterology and Hepatology, Virginia Mason Medical Center, Seattle, WA, USA
    • Divisions of Gastroenterology and Hepatology, University of California, San Francisco, CA, USA
    • Divisions of Gastroenterology and Hepatology, University of Miami, Miami, FL, USA
    • Divisions of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, AZ, USA
    • Divisions of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, PA, USA
    • ,
  • Bob Etemad

      Affiliations

    • Divisions of Gastroenterology and Hepatology, Mayo Clinic, 6A Davis Bldg., 4500 San Pablo Road, Jacksonville, FL 32224, USA
    • Divisions of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD, USA
    • Divisions of Gastroenterology and Hepatology, Ochsner Clinic, New Orleans, LA, USA
    • Divisions of Gastroenterology and Hepatology, University of Maryland, Baltimore, MD, USA
    • Divisions of Gastroenterology and Hepatology, Duke University, Durham, NC, USA
    • Divisions of Gastroenterology and Hepatology, Virginia Mason Medical Center, Seattle, WA, USA
    • Divisions of Gastroenterology and Hepatology, University of California, San Francisco, CA, USA
    • Divisions of Gastroenterology and Hepatology, University of Miami, Miami, FL, USA
    • Divisions of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, AZ, USA
    • Divisions of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, PA, USA
    • ,
  • Bruce Greenwald

      Affiliations

    • Divisions of Gastroenterology and Hepatology, University of Maryland, Baltimore, MD, USA
    • ,
  • Frank Gress

      Affiliations

    • Divisions of Gastroenterology and Hepatology, Mayo Clinic, 6A Davis Bldg., 4500 San Pablo Road, Jacksonville, FL 32224, USA
    • Divisions of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD, USA
    • Divisions of Gastroenterology and Hepatology, Ochsner Clinic, New Orleans, LA, USA
    • Divisions of Gastroenterology and Hepatology, University of Maryland, Baltimore, MD, USA
    • Divisions of Gastroenterology and Hepatology, Duke University, Durham, NC, USA
    • Divisions of Gastroenterology and Hepatology, Virginia Mason Medical Center, Seattle, WA, USA
    • Divisions of Gastroenterology and Hepatology, University of California, San Francisco, CA, USA
    • Divisions of Gastroenterology and Hepatology, University of Miami, Miami, FL, USA
    • Divisions of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, AZ, USA
    • Divisions of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, PA, USA
    • ,
  • Drew Schembre

      Affiliations

    • Divisions of Gastroenterology and Hepatology, Mayo Clinic, 6A Davis Bldg., 4500 San Pablo Road, Jacksonville, FL 32224, USA
    • Divisions of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD, USA
    • Divisions of Gastroenterology and Hepatology, Ochsner Clinic, New Orleans, LA, USA
    • Divisions of Gastroenterology and Hepatology, University of Maryland, Baltimore, MD, USA
    • Divisions of Gastroenterology and Hepatology, Duke University, Durham, NC, USA
    • Divisions of Gastroenterology and Hepatology, Virginia Mason Medical Center, Seattle, WA, USA
    • Divisions of Gastroenterology and Hepatology, University of California, San Francisco, CA, USA
    • Divisions of Gastroenterology and Hepatology, University of Miami, Miami, FL, USA
    • Divisions of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, AZ, USA
    • Divisions of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, PA, USA
    • ,
  • V. Raman Muthusamy

      Affiliations

    • Divisions of Gastroenterology and Hepatology, Mayo Clinic, 6A Davis Bldg., 4500 San Pablo Road, Jacksonville, FL 32224, USA
    • Divisions of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD, USA
    • Divisions of Gastroenterology and Hepatology, Ochsner Clinic, New Orleans, LA, USA
    • Divisions of Gastroenterology and Hepatology, University of Maryland, Baltimore, MD, USA
    • Divisions of Gastroenterology and Hepatology, Duke University, Durham, NC, USA
    • Divisions of Gastroenterology and Hepatology, Virginia Mason Medical Center, Seattle, WA, USA
    • Divisions of Gastroenterology and Hepatology, University of California, San Francisco, CA, USA
    • Divisions of Gastroenterology and Hepatology, University of Miami, Miami, FL, USA
    • Divisions of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, AZ, USA
    • Divisions of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, PA, USA
    • ,
  • Afonso Ribeiro

      Affiliations

    • Divisions of Gastroenterology and Hepatology, Mayo Clinic, 6A Davis Bldg., 4500 San Pablo Road, Jacksonville, FL 32224, USA
    • Divisions of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD, USA
    • Divisions of Gastroenterology and Hepatology, Ochsner Clinic, New Orleans, LA, USA
    • Divisions of Gastroenterology and Hepatology, University of Maryland, Baltimore, MD, USA
    • Divisions of Gastroenterology and Hepatology, Duke University, Durham, NC, USA
    • Divisions of Gastroenterology and Hepatology, Virginia Mason Medical Center, Seattle, WA, USA
    • Divisions of Gastroenterology and Hepatology, University of California, San Francisco, CA, USA
    • Divisions of Gastroenterology and Hepatology, University of Miami, Miami, FL, USA
    • Divisions of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, AZ, USA
    • Divisions of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, PA, USA
    • ,
  • Virender Sharma

      Affiliations

    • Divisions of Gastroenterology and Hepatology, Mayo Clinic, 6A Davis Bldg., 4500 San Pablo Road, Jacksonville, FL 32224, USA
    • Divisions of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD, USA
    • Divisions of Gastroenterology and Hepatology, Ochsner Clinic, New Orleans, LA, USA
    • Divisions of Gastroenterology and Hepatology, University of Maryland, Baltimore, MD, USA
    • Divisions of Gastroenterology and Hepatology, Duke University, Durham, NC, USA
    • Divisions of Gastroenterology and Hepatology, Virginia Mason Medical Center, Seattle, WA, USA
    • Divisions of Gastroenterology and Hepatology, University of California, San Francisco, CA, USA
    • Divisions of Gastroenterology and Hepatology, University of Miami, Miami, FL, USA
    • Divisions of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, AZ, USA
    • Divisions of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, PA, USA
    • ,
  • Gregory Ginsberg

      Affiliations

    • Divisions of Gastroenterology and Hepatology, Mayo Clinic, 6A Davis Bldg., 4500 San Pablo Road, Jacksonville, FL 32224, USA
    • Divisions of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD, USA
    • Divisions of Gastroenterology and Hepatology, Ochsner Clinic, New Orleans, LA, USA
    • Divisions of Gastroenterology and Hepatology, University of Maryland, Baltimore, MD, USA
    • Divisions of Gastroenterology and Hepatology, Duke University, Durham, NC, USA
    • Divisions of Gastroenterology and Hepatology, Virginia Mason Medical Center, Seattle, WA, USA
    • Divisions of Gastroenterology and Hepatology, University of California, San Francisco, CA, USA
    • Divisions of Gastroenterology and Hepatology, University of Miami, Miami, FL, USA
    • Divisions of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, AZ, USA
    • Divisions of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, PA, USA

published online 24 April 2006.

Summary 

During Digestive Disease Week 2005 in Chicago, Illinois, our group of 10 gastrointestinal photodynamic therapists met to discuss variations in procedural technique and treatment protocols. An extensive review of the use of photodynamic therapy (PDT) for esophageal disease has recently been published elsewhere [Wolfsen HC. Present status of photodynamic therapy for high-grade dysplasia in Barrett's esophagus. J Clin Gastroenterol 2005;39(3):189–202]. This report, based mostly on clinical experience and common sense rather than evidence-based medicine, is a detailed discussion of pragmatic issues. In summary, our centers treat patients with Barrett's dysplasia, Barrett's or squamous cell carcinoma using the photosensitizer porfimer sodium (2mg/kg total body weight) and bare fiber PDT (no fiber centering devices). Aggressive suppression of gastric acid is uniformly emphasized. The most common technique variables were the light energy source, light dosimetry and the amount of Barrett's mucosa treated during a course of PDT. Standardization of porfimer sodium PDT procedures and light dosimetry may enhance treatment outcomes.

Keywords: Endoscopic ultrasound, Endobronchial ultrasound, Phototoxicity, Stricture, Lung cancer

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PII: S1572-1000(06)00053-6

doi:10.1016/j.pdpdt.2006.03.004

Photodiagnosis and Photodynamic Therapy
Volume 3, Issue 2 , Pages 87-92, June 2006

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