Trial reportLasers in medical science2013
A randomised controlled trial of ALA vs. Photofrin photodynamic therapy for high-grade dysplasia arising in Barrett's oesophagus.
Trial report in Lasers in medical science, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 58 citations in OpenAlex.
- Guideline
- Emerging uses of 5-aminolevulinic-acid-induced protoporphyrin IX in medicine: a review of multifaceted, ubiquitous, molecular diagnostic, therapeutic, and theranostic opportunities.Journal of biomedical optics · 2025Review
- Highly functional duodenal stent with photosensitizers enables photodynamic therapy for metabolic syndrome treatment: Feasibility and safety study in a porcine model.APL bioengineering · 2024Article
- Advancements in photodynamic therapy of esophageal cancer.Frontiers in oncology · 2022Review
- Endoscopic therapies for Barrett's esophagus.Translational gastroenterology and hepatology · 2021Review
- Efficacy of 5-aminolevulinic acid-mediated photodynamic therapy in a mouse model of esophageal cancer.Oncology letters · 2020Article
- Indications, contraindications and limitations of endoscopic therapy for Barrett's esophagus and early esophageal adenocarcinoma.Therapeutic advances in gastroenterology · 2020Review
- Endoscopic therapy for Barrett's esophagus and early esophageal cancer: Where do we go from here?World journal of gastrointestinal endoscopy · 2018Review
- Article
- Oncologic Photodynamic Therapy: Basic Principles, Current Clinical Status and Future Directions.Cancers · 2017Review
- Endoscopic treatments for dysplastic Barrett's esophagus: resection, ablation, what else?World journal of surgery · 2015Review
- Endoscopic assessment and management of early esophageal adenocarcinoma.World journal of gastrointestinal oncology · 2014Review
- Treatment of dysplasia in barrett esophagus.Clinical endoscopy · 2014Review
- Techniques for fluorescence detection of protoporphyrin IX in skin cancers associated with photodynamic therapy.Photonics & lasers in medicine · 2013Article
- Photodynamic therapy in gastroenterology.Journal of gastrointestinal cancer · 2013Review
- Photodynamic Therapy for Barrett's Esophagus and Esophageal Carcinoma.Clinical endoscopy · 2013Article
- Endoscopic palliation of advanced esophageal cancer.Journal of medicine and lifeArticle
- The role of ablation in the treatment of dysplastic Barrett's esophagus.Therapeutic advances in gastrointestinal endoscopyReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 2 institutions in 1 country.
Funding
Abstract
Photofrin photodynamic therapy (PDT) is a licenced treatment for Barrett's oesophagus (BE) with high-grade dysplasia (HGD) but causes strictures and photosensitivity and complete reversal of dysplasia (CR-HGD) by 50 % at 5 years. 5-Aminolaevulinic acid (ALA) is an alternative treatment with non-randomised data suggesting 85 % CR-HGD and a low risk of side effects. We aimed to compare efficacy and side effect profile between the drugs. A single-centre randomised controlled trial was conducted. Presence of HGD was confirmed on three occasions by two specialist GI pathologists. Stratification was by length of BE and extent of dysplasia. Standard protocols for ALA and Photofrin-PDT were followed. Endoscopic follow-up with 2-cm four-quadrant biopsy was at 6 weeks, 4 months, and then annually. All adverse event data were collected. Sixty four patients were randomised, 34 ALA and 30 Photofrin-PDT. Median follow-up is 24 months. On intention-to-treat analysis, CR-HGD was 16/34 (47 %) with ALA-PDT and 12/30 (40 %) with Photofrin-PDT. The overall cancer incidence was 14 % (9/64). On sub-group log-rank analysis, for BE ≤ 6 cm, CR-HGD was significantly higher with ALA-PDT than Photofrin-PDT (χ(2) =5.39, p=0.02). Strictures and skin photosensitivity were significantly more common after treatment with Photofrin-PDT than ALA-PDT (33 vs. 9 % and 43 vs. 6 %, respectively, p<0.05). The rate of buried glands with either drug was significantly higher post-PDT (48 % of patients) than pre-PDT (20 %). ALA-PDT has a better risk profile than Photofrin-PDT. In patients with BE length ≤ 6 cm, preliminary results show ALA-PDT is associated with significantly higher CR-HGD. In longer segments of BE, neither PDT drug is sufficiently efficacious to warrant routine use.
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