CHAPTER 23: Photodynamic Therapy in Gastroenterology

Photodynamic therapy (PDT) in gastroenterology is an anti-neoplastic treatment based on the photosensitization of neoplasms following the administration of a photosensitizer prior to laser light-induced tissue destruction. PDT is effective in the palliative treatment of hilar cholangiocarcinoma and can be used in endoscopically accessible lesions located within the esophagus, the stomach, the bile duct or the colorectal tract in patients with high surgical risk. However, significant drawbacks to PDT have caused a decrease in the use of PDT in gastroenterology. In order to change the status of PDT from “an emerging alternative to standard care in anticancer therapy,” well-designed clinical studies with the existing photosensitizers are still necessary. Controlled and reproducible illumination should be a mainstay for efficient PDT. The enhancement of PDT efficacy by combining it with other therapies should be considered.