Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Photodynamic therapy (PDT) is a promising technique for producing localized destruction of small cancers in the gastrointestinal tract. Following prior intravenous administration of a photosensitizing drug, the tumour area is exposed to low power red light from a laser. There is a small degree of selectivity for tumour areas, but even if there is damage to normal tissues, this heals by regeneration. Thus the tumour and a surrounding cuff of normal tissue can be treated without the need for surgery and with safe healing of all treated areas without risk of perforation. There are 2 main problems. PDT can only be applied to small tumours (up to 1-2 cm thick) partly because the red light used only penetrates a few mm into tissue, but also because there is a risk of delayed haemorrhage following partial necrosis of large lesions. However, it may be complementary to other techniques. If the main bulk of a cancer is removed by surgery, PDT may be able to destroy any small areas of remaining cancer that are not accessible for resection. The other problem is that the most frequently used photosensitizer, haematoporphyrin derivative (HpD), leaves the patient sensitive to sunlight for several weeks after treatment. This will be much less of a problem with the newer photosensitizers such as aluminium sulphonated phthalocyanines and amino laevulinic acid, both of which should be ready for preliminary clinical trials within a few months. PDT has been applied on its own for the palliation of dysphagia from advanced oesophageal cancers, but the results as far are purely anecdotal and it seems unlikely that this will prove a useful approach unless PDT is combined with other therapies. The potential for PDT in treating gastrointestinal tumours is great, but a careful understanding of the biology involved is essential before this can be realized.
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PMID:Photodynamic therapy in gastroenterology--current status and future prospects. 750 44

A case of adenocarcinoma in the pharyngo oesophageal junction extending to the upper cervical oesophagus is described. In this case the neo-plastic changes had occurred from columnar epithelium of gastric and intestinal type: Barrett's oesophagus. The Barrett's mucosa involved the whole length of the oesophagus. Because of the general condition of the patient and advanced stage of the tumour surgical treatment was considered inappropriate. Endoscopic Photofrin Photodynamic Therapy was used with good palliation of dysphagia. The patient survived for 9 months, dying form carcinomatosis and oesophago-airway fistula. As far as can be documented only one such case has been previously reported in the literature.
Photodiagnosis Photodyn Ther 2008 Sep
PMID:Adeno-carcinoma of the pharyngo-oesophageal junction and cervical oesophagus in a patient with an oesophagus lined entirely by columnar epithelium report of a case treated by photodynamic therapy (PDT). 1935 59

Endoscopic photodynamic therapy (PDT) is undertaken only when tumour is visible endoscopically with malignancy biopsy confirmed. Patients will be either Group A: inoperable cases with locally advanced cancer when the aim is palliation of dysphagia, or Group E: patients with early stage I-II disease who are unsuitable for surgery or decline operation, when the intent is curative. Following assessment for suitability for PDT and counselling, Photofrin 2mg/(kgbw) is administered 24-72h before endoscopic illumination using a Diode 630nm laser. Illumination may be either interstitial or intraluminal at a dose of 100-200J/cm.
Photodiagnosis Photodyn Ther 2006 Jun
PMID:Endoscopic photodynamic therapy (PDT) for oesophageal cancer. 2504 97