Sánchez A, Reza M, Blasco JA, Callejo D. Effectiveness, safety, and cost-effectiveness of photodynamic therapy in Barrett's esophagus: a systematic review. Dis Esophagus 2010 Nov;23(8):633-40 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/20545970.
systematic review — The review includes studies examining the use of PDT in the treatment of Barrett's oesophagus. Randomised clinical trials involving humans were included that looked at either treatment of Barrett's oesophagus or cost efficacy. Duplicated, foreign language studies and uncontrolled studies were excluded. Combination therapies or evaluation of new techniques were not included.
|High risk of bias||Comments: There was no attempt to combine any of the data or apply any form of statistical assessment. The paper was purely descriptive of the literature. There were significant variations in the methods of the studies including significant differences in the photosensitisers used. In 4 of the included 12 papers, the photosensitiser was not stated. Patient inclusion varied from dysplastic Barrett's through to groups without dysplasia and the length of treated Barrett's also varied significantly. Finally the PDT was compared to a variety of "control" groups including those treated with APC, oesophagectomy, placebo, endoscopic follow up or NO follow up. The summary of cost efficacy showed huge variation in costs making interpretation relatively uncertain.|
Risk of bias assessment: systematic review
Studies included in the review
- Very thorough – included appropriate search terms and databases
- No – inclusion was decided in an arbitrary fashion or not described
- Adequate – some problems with quality issues or assessed by one person only
- Adequate – more information would be desirable
The following questions are only relevant for systematic reviews that pooled data
|5||Reason for decision: The included studies show significant heterogeneity of included patients. Most studies where quoted had low numbers of patients. No statistical methods were applied in this paper.|
|2||Additional comments: The reviewed literature consistently showed that PDT was able to effective ablate Barrett's oesophagus|
I have included the paper as it does summarise the clinical experience in using PDT in the treatment of Barrett's oesophagus. The end points are weak but the value of the paper is that it clearly shows that PDT can ablate Barrett's mucosa. The side effects and complications of this therapy received scant attention.
- Sánchez A, Reza M, Blasco JA, Callejo D. Effectiveness, safety, and cost-effectiveness of photodynamic therapy in Barrett's esophagus: a systematic review. Dis Esophagus 2010 Nov;23(8):633-40 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/20545970.
- Assigned to
- Topic area
- Clinical question
Section below only relevant for Cancer Council Project Officer