Seven RCTs were included in the review (n=432 participants, range 21 to 208). Only one trial was double blind. Three trials did not report the randomisation procedure. Follow-up ranged from one month to five years. Most trials had small sample sizes. In the largest trial a very high proportion of patients (41% and 62% at two years in the two treatment groups) were lost to follow-up; the study authors suggested that the main reasons for losses were progression of dysplasia and need for other treatment.
Five trials compared photodynamic therapy with argon plasma coagulation. Two of four trials that assessed ablation or eradication of Barrett's oesophagus favoured argon plasma coagulation; two trials reported no difference in eradication rates and one of these trials showed no effect in either treatment group. One trial reported significantly higher rates of eradication of dysplasia in the photodynamic therapy group.
Two trials compared photodynamic therapy in combination with omeprazole versus omeprazole alone in patients with Barrett's oesophagus and high-grade dysplasia. In both trials the results favoured photodynamic therapy; in one trial fewer patients went on to develop cancer in the photodynamic therapy group.
Five trials reported adverse events. The authors stated that adverse event rates were generally high. Adverse events were generally more frequent in the photodynamic therapy group than the control group.