Featured Research

from universities, journals, and other organizations

Technique Eradicates Problems In Most Patients With Barrett's Esophagus

Date:
May 28, 2009
Source:
Washington University School of Medicine
Summary:
A procedure that uses heat generated by radio waves to treat Barrett's esophagus, a condition caused by acid reflux (severe heartburn), can eliminate signs of the potentially cancer-causing disorder and reduce the risk that the disease will progress. The procedure, called radiofrequency ablation, could mean patients have an alternative to surgery for treating Barrett's esophagus.

A procedure that uses heat generated by radio waves to treat Barrett's esophagus, a condition caused by acid reflux (severe heartburn), can eliminate signs of the potentially cancer-causing disorder and reduce the risk that the disease will progress.

Related Articles


Findings from the first multicenter trial of the procedure, called radiofrequency ablation, could mean patients have an alternative to surgery for treating Barrett's esophagus. The procedure uses a scope inserted through the mouth to destroy the abnormal tissue.

"Patients with Barrett's esophagus can go on to develop esophageal cancer," says Steven A. Edmundowicz, M.D., lead investigator at the study site at Washington University School of Medicine in St. Louis. "Cancer of the esophagus usually is deadly. Less than 15 percent of patients with esophageal adenocarcinoma survive for five years, and in those with advanced Barrett's esophagus, the risk that the condition will advance to become cancer is about 6 percent per year."

In Barrett's esophagus, part of the lining of the esophagus is replaced with cells that resemble intestinal cells. As the condition progresses, these cells become increasingly disordered. Long-standing acid reflux disease is common in those who develop Barrett's esophagus, which affects about 1 percent of adults in the United States.

A total of 127 patients at 19 sites took part in the study, which used endoscopes to diagnose the disease and then to deliver radiofrequency ablation to the abnormal lining of the esophagus. The technique heats the abnormal tissue to destroy it while leaving the deeper layers of the esophagus undamaged.

All patients in the study had the disordered, cellular growth called dysplasia associated with more advanced Barrett's esophagus. Patients were classified as having either low-grade dysplasia or high-grade dysplasia. Regardless of how they were classified for the study, patients received the anti-reflux medication esomeprazole (Nexium), to keep their reflux disease in check as much as possible.

Led by Nicholas J. Shaheen, M.D., at the University of North Carolina at Chapel Hill, the investigators at the various study sites randomly selected patients to either receive radiofrequency ablation or to undergo a sham procedure in which endoscopes were inserted through the mouth and the lining of the esophagus was examined, but no radio waves were delivered.

Two patients received the actual treatment for every one who got a sham procedure. Those who received the ablation treatment could get up to four treatments during the 12 months of the study. Following the study period, those who had not received ablation therapy were given the option of getting the treatment.

In the patients who had the treatment, dysplasia disappeared in just over 90 percent of patients with low-grade disease and in more than 80 percent of those with high-grade disease compared to about 23 percent of the low-grade patients and 19 percent of the high-grade patients who had sham procedures rather than the ablation therapy. In 78 percent of treated patients, not only did dysplasia disappear, but all the abnormal intestinal-type cells were eliminated as well.

"During the 12-month study period, we detected fewer cancers in the ablation group than in the control group," says Edmundowicz, a professor of medicine in the Division of Gastroenterology. "But because cancers occurred in a total of only five study patients, the numbers are not as powerful regarding cancer as they are regarding eradication of Barrett's esophagus."

The risk of progressing from Barrett's esophagus to esophageal cancer is approximately 1 percent for those with low-grade dysplasia and 6 percent for those with high-grade disease.

"From these short term results, it appears we may have another useful tool in our treatment arsenal," says Edmundowicz, who is a staff physician at Barnes-Jewish Hospital and a gastroenterologist at the Siteman Cancer Center. "Additional follow-up will be necessary to demonstrate the true effectiveness of radiofrequency ablation in preventing esophageal cancer in patients with Barrett's esophagus. "

Most study subjects tolerated the treatments very well, he says. "The one side effect that most ablation patients experienced was soreness in the chest following therapy, this was easily managed with medications, and they were less sore than if they had surgery, which has been the primary treatment option," he says.

The surgical option is offered to patients with Barrett's esophagus found to have severe dysplasia or cancer. The type of surgery varies, but it usually involves removing most of the esophagus, pulling a portion of the stomach up into the chest and attaching it to what remains of the esophagus.

The study was supported by BARRX Medical, which manufactures the ablation device. All patients in the study also received the anti-reflux drug. Edmundowicz has received lecture support from BARRX Medical.

Study medication was provided by AstraZeneca. Statistical analysis and data management were supported by a grant from the National Institutes of Health.

Other sites involved in the study included the University of North Carolina at Chapel Hill; Veterans Affairs Medical Center and University of Kansas School of Medicine, Kansas City, Mo.; Gastrointestinal Associates, Knoxville, Tenn.; Mayo Clinic Jacksonville, Jacksonville, Fla.; South Arizona Veterans Affairs Health Care System, Tucson; Mayo Clinic Rochester, Rochester, Minn.; Cleveland Clinic, Cleveland; Oregon Health and Sciences University, Portland; Mayo Clinic Arizona, Scottsdale; Medical University of South Carolina, Charleston; Dartmouth-Hitchcock Medical Center, Lebanon, N.H.; Veterans Affairs Boston Healthcare System, West Roxbury, Mass.; University of California, Irvine, Orange; University of Texas Southwestern Medical Center, Dallas; Thomas Jefferson University, Philadelphia; Tacoma Digestive Disease Research Center, Tacoma, Wash.; University Hospitals – Case Medical Center, Cleveland; and Columbia University Medical Center, New York.


Story Source:

The above story is based on materials provided by Washington University School of Medicine. Note: Materials may be edited for content and length.


Journal Reference:

  1. Shaheen NJ, et al. Radiofrequency ablation in Barrett's esophagus with dysplasia. New England Journal of Medicine, vol 330 (22), May 28, 2009 [link]

Cite This Page:

Washington University School of Medicine. "Technique Eradicates Problems In Most Patients With Barrett's Esophagus." ScienceDaily. ScienceDaily, 28 May 2009. <www.sciencedaily.com/releases/2009/05/090522131932.htm>.
Washington University School of Medicine. (2009, May 28). Technique Eradicates Problems In Most Patients With Barrett's Esophagus. ScienceDaily. Retrieved October 25, 2014 from www.sciencedaily.com/releases/2009/05/090522131932.htm
Washington University School of Medicine. "Technique Eradicates Problems In Most Patients With Barrett's Esophagus." ScienceDaily. www.sciencedaily.com/releases/2009/05/090522131932.htm (accessed October 25, 2014).

Share This



More Health & Medicine News

Saturday, October 25, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

IKEA Desk Converts From Standing to Sitting With One Button

IKEA Desk Converts From Standing to Sitting With One Button

Buzz60 (Oct. 24, 2014) IKEA is out with a new convertible desk that can convert from a sitting desk to a standing one with just the push of a button. Jen Markham explains. Video provided by Buzz60
Powered by NewsLook.com
Ebola Protective Suits Being Made in China

Ebola Protective Suits Being Made in China

AFP (Oct. 24, 2014) A factory in China is busy making Ebola protective suits for healthcare workers and others fighting the spread of the virus. Duration: 00:38 Video provided by AFP
Powered by NewsLook.com
WHO: Millions of Ebola Vaccine Doses by 2015

WHO: Millions of Ebola Vaccine Doses by 2015

AP (Oct. 24, 2014) The World Health Organization said on Friday that millions of doses of two experimental Ebola vaccines could be ready for use in 2015 and five more experimental vaccines would start being tested in March. (Oct. 24) Video provided by AP
Powered by NewsLook.com
Doctor in NYC Quarantined With Ebola

Doctor in NYC Quarantined With Ebola

AP (Oct. 24, 2014) An emergency room doctor who recently returned to the city after treating Ebola patients in West Africa has tested positive for the virus. He's quarantined in a hospital. (Oct. 24) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins