Author：Prasad GA, Wang KK, Buttar NS, Wongkeesong LM, Krishnadath KK, Nichols FC 3rd, Lutzke LS, Borkenhagen LS.
Resource: Gastroenterology. 2007 Feb 7
Abstract：BACKGROUND & AIMS: Photodynamic therapy (PDT) for high-grade dysplasia (HGD) in Barrett's esophagus is a Food and Drug Administration-approved alternative to esophagectomy. Critical information regarding overall survival of patients followed up long-term after these therapies is lacking. Our aim was to compare the long-term survival of patients treated with PDT with patients treated with esophagectomy. METHODS: We reviewed records of patients with HGD seen at our institution between 1994 and 2004. PDT was performed 48 hours following the intravenous administration of a photosensitizer using light at 630 nm. Esophagectomy was performed by either transhiatal or transthoracic approaches by experienced surgeons. We excluded all patients with evidence of cancer on biopsy specimens. Vital status and death date information was queried using an institutionally approved Internet research and location service. Statistical analysis was performed using Kaplan-Meier curves and Cox proportional hazards ratios. RESULTS: A total of 199 patients were identified. A total of 129 patients (65%) were treated with PDT and 70 (35%) with esophagectomy. Overall mortality in the PDT group was 9% (11/129) and in the surgery group was 8.5% (6/70) over a median follow-up period of 59 +/- 2.7 months for the PDT group and 61 +/- 5.8 months for the surgery group. Overall survival was similar between the 2 groups (Wilcoxon test = 0.0924; P = .76). Treatment modality was not a significant predictor of mortality on multivariate analysis. CONCLUSIONS: Overall mortality and long-term survival in patients with HGD treated with PDT appears to be comparable to that of patients treated with esophagectomy.
PMID: 17408660
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Title：Long-Term Survival Following Endoscopic and Surgical Treatment of High-Grade Dysplasia in Barrett's Esophagus.
标题：高度异型增生的Barrett食管，内镜or手术?
Author：Prasad GA, Wang KK, Buttar NS, Wongkeesong LM, Krishnadath KK, Nichols FC 3rd, Lutzke LS, Borkenhagen LS.
作者：Prasad GA, Wang KK, Buttar NS, Wongkeesong LM, Krishnadath KK, Nichols FC 3rd, Lutzke LS, Borkenhagen LS.
Resource: Gastroenterology. 2007 Feb 7
文章来源：胃肠病学.2007.2.7
Abstract：BACKGROUND & AIMS: Photodynamic therapy (PDT) for high-grade dysplasia (HGD) in Barrett's esophagus is a Food and Drug Administration-approved alternative to esophagectomy. Critical information regarding overall survival of patients followed up long-term after these therapies is lacking.
摘要：
背景和目的：
对高度异型增生(HGD)的Barrett食管进行光动力疗法（PDT）治疗是食品药品管理局批准的除食管切除术外的另一选择。然而缺乏这些治疗后患者总存活数的关键长期随访信息。
Our aim was to compare the long-term survival of patients treated with PDT with patients treated with esophagectomy.
我们的目的是比较经PDT治疗和进行食管切除术后患者的长期存活率。
METHODS: We reviewed records of patients with HGD seen at our institution between 1994 and 2004. PDT was performed 48 hours following the intravenous administration of a photosensitizer using light at 630 nm.
方法：
我们考查1994-2004年间在我们机构发现HGD的患者记录。静脉内给予630 nm光敏剂48h后进行PDT治疗。
Esophagectomy was performed by either transhiatal or transthoracic approaches by experienced surgeons. We excluded all patients with evidence of cancer on biopsy specimens. Vital status and death date information was queried using an institutionally approved Internet research and location service.
由经验丰富的外科医师经膈或经胸腔进行食管切除术。我们排除所有在活检标本中有癌症迹象的患者。通过批准的常用因特网调查和地区服务得到患者的重要数据和死亡日期信息。
Statistical analysis was performed using Kaplan-Meier curves and Cox proportional hazards ratios.
通过Kaplan-Meier曲线和Cox比例风险比率进行统计分析。
RESULTS: A total of 199 patients were identified. A total of 129 patients (65%) were treated with PDT and 70 (35%) with esophagectomy.
结果：
共对199名患者进行调查。共有129名患者(65%)进行了PDT治疗，70名 (35%)进行食管切除术。
Overall mortality in the PDT group was 9% (11/129) and in the surgery group was 8.5% (6/70) over a median follow-up period of 59 +/- 2.7 months for the PDT group and 61 +/- 5.8 months for the surgery group.
PDT组中位59 +/- 2.7个月的随访期内总死亡率为9% (11/129)，手术组61 +/- 5.8个月的中位随访期内总死亡率为8.5% (6/70)。
Overall survival was similar between the 2 groups (Wilcoxon test = 0.0924; P = .76). Treatment modality was not a significant predictor of mortality on multivariate analysis.
2组的总存活率相似(Wilcoxon检验 = 0.0924; P = .76)。多变量分析中，治疗模式无明显的死亡预示。
CONCLUSIONS: Overall mortality and long-term survival in patients with HGD treated with PDT appears to be comparable to that of patients treated with esophagectomy.
结论：
研究显示，采用PDT治疗HGD患者，其总死亡率和长期存活率与食管切除术治疗相当。
PMID: 17408660
编译：
对于高度异型增生(HGD)的Barrett食管进行光动力疗法（PDT）治疗是食品药品管理局批准的除食管切除术外的另一选择。然而却缺乏这些治疗后患者总存活数的关键长期随访信息。因此Prasad GA等研究人员为了比较PDT治疗和食管切除术后患者的长期存活率而进行了相关的考查研究。（Gastroenterology. 2007 Feb 7）
研究人员考查1994-2004年间在其机构发现HGD的患者记录。其在静脉内给予630 nm光敏剂48h后进行PDT治疗。或由经验丰富的外科医师经膈或经胸腔进行食管切除术。研究排除所有活检标本中有癌症迹象的患者。通过批准的常用的因特网调查和地区服务来获得重要数据和死亡日期信息。然后用Kaplan-Meier曲线和Cox比例风险比值进行统计分析。共对199名患者进行调查，其中129名患者(65%)进行了PDT治疗，70名 (35%)进行食管切除术。结果发现，PDT组中位59 +/- 2.7个月的随访期内总死亡率为9% (11/129)，手术组61 +/- 5.8个月的中位随访期内总死亡率为8.5% (6/70)。2组的总存活率相似(Wilcoxon 检验 = 0.0924; P = .76)。多变量分析中，治疗模式无明显的死亡预示。研究显示，采用PDT治疗HGD患者，其总死亡率和长期存活率与食管切除术治疗相当。（丁香）
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