Evidence-based recommendations on photodynamic therapy for Barrett's oesophagus. This involves using a light-activated drug (called a photosensitising agent) with a laser to destroy the abnormal cells and to promote the growth of healthy cells.
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. This interventional procedures guidance on photodynamic therapy for Barrett's oesophagus remains current, and should be read in conjunction with the clinical guideline.
Is this guidance up to date?
Next review: this guidance will be reviewed if there is new evidence or safety concerns.
Guidance development process
This guidance replaces the previous interventional procedure guidance on photodynamic therapy for Barrett's oesophagus (IPG82).
This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account, and specifically any special arrangements relating to the introduction of new interventional procedures. The guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties. Providers should ensure that governance structures are in place to review, authorise and monitor the introduction of new devices and procedures.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.