The National Institute for Health and Care Excellence (NICE) issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on selective internal radiation therapy for unresectable primary intrahepatic cholangiocarcinoma in July 2013. NICE is currently updating this guidance. The new guidance will be published shortly. Until then the NHS should continue to follow the recommendations outlined in the current version of the guidance. The Interventional Procedures Advisory Committee (IPAC) will consider this procedure review and NICE will issue an interventional procedures consultation document about its safety and efficacy for 4 weeks’ public consultation. IPAC will then review the consultation document in the light of comments received and produce a final interventional procedures document, which will be considered by NICE before guidance is issued to the NHS in England, Wales, Scotland and Northern Ireland.
 
Status In progress
Process IP
Description SIRT involves delivering microspheres containing radionuclides such as yttrium-90 (Y-90) or holmium-166 (Ho-166) that emit beta or gamma radiation directly into the tumour via the hepatic artery. Under local anaesthesia with fluoroscopic guidance, the radioactive microspheres, which are made of glass, resin or poly(L-lactic) acid, are injected into branches of the hepatic artery supplying the tumour. Usually, the percutaneous femoral or radial approach is used. The beads are designed to lodge in the small arteries surrounding the tumour and release high doses of localised radiation directly into the liver. The procedure may be repeated depending on the response.

Provisional Schedule

Expected publication 31 October 2018

Timeline

Key events during the development of the guidance:

Date Update
24 May 2018 - 21 June 2018 Interventional procedure consultation

For further information on how we develop guidance, please see our page about NICE interventional procedures guidance