B151
Quality of life following ALA v Photofrin PDT for Dysplastic Barretts Oesophagus - preliminary results of a randomised controlled trial
Sally Thorpe, Jason Dunn, Gary Mackenzie, Stephen Bown, Laurence Lovat
University College London, UK
Background
Photodynamic therapy (PDT) with Photofrin is a licensed minimally invasive treatment for high grade dysplasia (HGD) in Barretts oesophagus (BE). Adverse events include strictures in 18-50%, and light sensitivity for three months. Chest pain and pleural effusions also occur. ALA is preferentially concentrated in the oesophageal mucosa so risk of stricturing is low. Light sensitivity for ALA lasts 36 hours. We aim to determine if ALA PDT is safer and better tolerated by patients than Photofrin PDT within a randomised control trial for HGD in BE.
Method
Patients with HGD in BE are randomised to 2mg/kg Photofrin or 60mg/kg ALA activated by 130J/cm or 1180J/cm red laser light respectively. All adverse events are recorded up to 1 year after treatment. Quality of life data were collected at enrolment, then at 5 time points in the first year after treatment. Participants are asked to complete STAI 6, Eortc QLQ Oes 18 and QOLRAD.
Results
50 patients have been treated, target recruitment is 66 patients. Skin photosensitivity reactions have occurred in 7/23 patients treated with Photofrin compared with 1/27 with ALA (p <0.05). There were 7/23 strictures with Photofrin compared with 3/27 with ALA (p=ns). Chest pain and problems with eating were more severe following Photofrin. Anxiety levels are similar at baseline but appear to fall consistently post ALA whilst remaining steady with Photofrin.
Conclusion
These data show that ALA PDT has a better side effect profile than Photofrin.
This work is supported by the CRUK Experimental Cancer Medicine Centre at UCL and the NIHR Comprehensive Biomedical Research Centre at UCLH.
