NICE has been notified about this procedure and it is part of its work programme. The Interventional Procedures Advisory Committee (IPAC) will consider this procedure 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
ID number 1724
Description Low-energy contact X-ray brachytherapy (CXB; the Papillion technique) for locally advanced inoperable rectal cancer may be given with external beam radiotherapy or chemotherapy or both. Low-energy CXB is usually delivered in a day-patient setting. The patient is given an enema before treatment, to empty the rectum. With the patient in a knee-to-chest, prone jack-knife or supine position, local anaesthesia and glyceryl trinitrate are applied to the anal sphincter to numb the area and relax the sphincter muscles. A sigmoidoscope is inserted through the anal sphincter to ascertain the size and position of the tumour. Subsequently, a rigid endorectal treatment applicator is inserted and placed in contact with the tumour. A contact X-ray tube is introduced into the applicator and emits low-energy X-rays that penetrate tissue by only a few millimetres, minimising damage to deeper tissues.

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Key events during the development of the guidance:

Date Update
26 February 2020 - 25 March 2020 Interventional procedure consultation

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