Photodynamic therapy and endoscopic mucosal resection as minimally invasive approaches for the treatment of early esophageal tumors: Pre-clinical and clinical experience in Lausanne

Temoporfin (Foscan®, 5,10,15,20‐Tetra(m‐hydroxyphenyl)chlorin)—A Second‐generation Photosensitizer†,‡

“…An analysis of the early studies in this area using various PS in the GI and aerodigestive tract was given by Radu et al. (371,374) and they discussed their experiences with PDT and endoscopic mucosal resection in Switzerland in detail (275).…”

“…With the assistance of fluorescence spectroscopy, an adjustment of the fluence rate to only 8-12 or 7-16 J cm )2 , respectively, was possible. An analysis of the early studies in this area using various PS in the GI and aerodigestive tract was given by Radu et al (371,374) and they discussed their experiences with PDT and endoscopic mucosal resection in Switzerland in detail (275).…”

“…One of the first animal studies related to esophageal cancer used a sheep model (275). A test of mucosal ablation through PDT in normal animals revealed significant complications in the esophagus following illumination with green light (514 nm) especially at high doses (276).…”

Assessment of a sheep animal model to optimise photodynamic therapy in the oesophagus

“…Oesophagectomy with its substantial mortality and morbidity rate is very unsatisfying as a preventive measure and regular surveillance is expensive and does not offer a definitive solution to the patient. Therefore, endoscopic ablative techniques are under investigation as minimally invasive alternatives [19][20][21][22][23]. Although several such therapies seem to be able to eradicate dysplasia and to replace at least partially Barrett's metaplasia, Photofrin 1 or 5-ALA PDT seem to have an advantage in terms of control and efficiency of the treatment, especially in the case of extended circumferential lesions [20,[24][25][26][27].…”

Oesophageal Burst Strength

“…Bursting strength measurement is an acceptable method, which assesses longitudinal and circular forces in hollow organs 3 . In this ex vivo study, we used a sheep oesophagus because of its similarities with that of humans regarding the thickness and histological structure 4 . Our study only designed for measuring instant mechanical stress and pressure in manual oesophageal closure.…”