1 Guidance

1 Guidance

1.1 Current evidence on the safety of photodynamic therapy (PDT) for early-stage oesophageal cancer appears adequate. PDT appears efficacious in reducing tumour bulk in carefully selected patients with small early-stage tumours. However, the current evidence is of poor quality and relates only to short-term outcomes; it is therefore not adequate to support the use of this procedure without special arrangements for consent, audit and clinical governance.

1.2 Clinicians wishing to undertake PDT for early-stage oesophageal cancer should take the following actions.

  • Inform the clinical governance leads in their Trusts.

  • Ensure that patients understand the uncertainty about the procedure's efficacy and provide them with clear written information. Use of the Institute's information for patients ('Understanding NICE guidance') is recommended.

  • Audit and review clinical outcomes of all patients having PDT for early-stage oesophageal cancer (see section 3.1).

1.3 Further research will be useful, and clinicians are encouraged to enter patients into well-designed trials and to collect longer-term follow-up data. The Institute may review the procedure upon publication of further evidence.