NICE recommends new breast cancer radiotherapy

An innovative new type of radiotherapy for breast cancer is set to be recommended for NHS patients in England under carefully controlled circumstances.

NICE is best known for producing guidance on drug therapy, but it is also increasingly appraising other medical interventions and medical devices.

The Intrabeam Radiotherapy System has been available for a number of years, and already has a high uptake in Germany, where manufacturers Carl Zeiss are based.

In the UK, however, only six centres have so far used the Intrabeam to treat early breast cancer, and NICE has concluded that the evidence base is still not mature.

NICE) has published draft guidance on the use of intrabeam radiotherapy as a option for people with early breast cancer. It says that the radiotherapy treatment should be recommended for NHS funding provided patients are properly informed about its pros and cons and that further data are collected.

Professor Carole Longson, director of health technology evaluation at NICE, said the treatment has the potential to be a much more efficient form of radiotherapy: “Unlike regular radiotherapy, with the Intrabeam Radiotherapy System only one dose is required.

“This single dose is given at the same time as surgery, eliminating the need for numerous hospital visits. Regular radiotherapy typically requires numerous doses over a three week period – although some people may receive it for longer – and is performed weeks or months after surgery or chemotherapy.

“The Appraisal Committee concluded that whilst current evidence was not extensive, this type of radiotherapy was more convenient for patients and can improve a person’s quality of life.”

Just over 41,500 women and 300 men in England are diagnosed with breast cancer every year. Figures suggest that about 86% of them – 35,970 people each year – will potentially have early breast cancer.

The draft guidance, published for consultation, says that intrabeam radiotherapy should be offered to NHS patients as long as doctors:

• explain the full range of treatment options available to patients, and their associated risks and benefits. This is to allow patients to make an informed decision about whether to choose Intrabeam or conventional radiotherapy.

• enter details about all of their breast cancer patients having treatment with the Intrabeam Radiotherapy System onto a national register.

• audit, review and document clinical outcomes locally and consider the relationship between outcomes and patients’ characteristics.

Professor Longson added: “Because it is still relatively new, it is only right to recommend its use in a carefully controlled way. This will ensure patients are fully aware of the risks and benefits before choosing which treatment to have and allow doctors to gather more information about the treatment.”

The institute’s public consultation runs until Friday 15 August 2014. Final guidance is expected to be published in November 2014. Until then, local NHS bodies are expected to make their own funding decisions for new treatments.

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