- All patients will have biopsy proven Barrett's esophagus with evidence of specialized
intestinal epithelium and dysplasia (either high grade dysplasia or low grade
dysplasia) on histology.
- Patients must have endoscopically visible segments of Barrett's esophagus of greater
than 1 centimeter in length.
- All patients must be eligible for longterm follow-up as well as tolerate endoscopy,
biopsy, and cytology.
- Patients must be willing to travel to Rochester, Minnesota for follow-up
- Patients must have a friend or relative accompany them on visits since sedatives will
render them unable to operate a motor vehicle
- If patients are on anticoagulation, they must be able to tolerate reversal of
anticoagulation for study biopsies and therapy
- All patients must be able to tolerate proton pump inhibitor therapy. Esomeprazole
will be provided but can be changed to another proton pump inhibitor if the patient
- All patients who have histological or cytological evidence of high grade dysplasia
will be seen by an experienced thoracic surgeon for consideration of esophagectomy.
- Patients who are unable to follow light avoidance instructions
- Patients with a history of prior esophageal surgery or successful fundoplication
- Patients who had prior photodynamic therapy
- Patients with pre-existing strictures in their esophagus
- Patients who have known allergies to porphyrin compounds
- Patients with a prior biopsies of Barrett's esophagus that contain carcinoma
- Patients who require continuous anti-coagulation
- Patients who are pregnant or are capable of pregnancy will be excluded from this
study unless they have been on effective birth control measures
- Lactating mothers are excluded from this study as it is unclear whether the
photosensitizer sodium porfimer can cross to the feeding infant
- Patients with underlying liver disease are excluded since their metabolism of
porphyrin based photosensitizers is uncertain. Evidence of liver disease will be an
transaminase elevation of three times normal, a bilirubin increase of twice normal,
or an alkaline phosphatase (liver fraction) elevation of twice normal.
- Patients who have underlying medical conditions that are felt to limit their survival
to less than one year.