The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Photodynamic therapy for Barrett's oesophagus.
It replaces the previous guidance on Photodynamic therapy for Barrett's oesophagus (NICE interventional procedure guidance 82, August 2004).
Further recommendations have been made as part of the clinical guideline on Barrett's oesophagus - ablative therapy published in August 2010, as follows:
Consider using radiofrequency ablation alone or photodynamic therapy alone for flat high-grade dysplasia, taking into account the evidence of their long-term efficacy, cost and complication rates.
Clinical and cost-effectiveness evidence was reviewed in the development of this guideline which has led to this more specific recommendation. More information is available from NICE clinical guidance 106. The IP guidance on photodynamic therapy for Barrett's oesophagus remains current, and should be read in conjunction with the clinical guideline.
Barrett’s oesophagus is a condition in which the internal lining of the gullet (oesophagus) becomes damaged by long-term leaking of the stomach contents back into the gullet, known as ‘reflux’. Some patients with Barrett’s oesophagus may go on to develop cancer of the oesophagus. In photodynamic therapy, the patient is injected with a drug that makes the affected lining of the oeosophagus sensitive to light. Some hours after this a laser light source is passed down into the oesophagus where it is used to start a reaction that destroys the abnormal lining of the oesophagus, with the aim of preventing the progression to cancer.
G14.7 Fibreoptic endoscopic photodynamic therapy of lesion of oesophagus