Photodynamic Therapy with Aminolevulinic Acid: a novel therapeutic Target in the Management of Gastrointestinal Malignancies

Surgery combined with chemoradiotherapy is the mainstay for the management of gastrointestinal malignancies. Ultimate goal is to eliminate locoregional recurrences, to prolong survival and to prevent morbidity and mortality associated with traditional treatment modalities in management of gastrointestinal malignancies. ,In this respect, Photodynamic Therapy (PDT) seems to be a good alternative treatment option for gastrointestinal malignancies because of its promising results in precancerous, cancerous and noncancerous lesions. Studies support the complete response with PDT in recurrent and advanced cases with gastrointestinal malignancies. Aminolevulinic acid (ALA) is a heme precursor leading to accumulation of the photosensitizer protoporphyrin IX (PpIX) in tissues that makes ALA useful target for PDT. Thus, PDT using ALA seems to be promising novel, advanced, an efficient, convenient approach in management of patients with gastrointestinal malignancies. This review highlights the principles of action mechanism of PDT with ALA, applications in gastrointestinal malignancies and limitations and its future directions in this field.