RCR response to NICE guidance on the use of Intrabeam therapy for breast cancer patients

Wednesday 31 January 2018

The National Institute for Health and Care Excellence (NICE) has today (31 January) published its guidance on the use of Intrabeam radiotherapy for breast cancer patients.

Dr Jeanette Dickson, Vice President, Clinical Oncology at The Royal College of Radiologists (RCR), said:

“The RCR is disappointed that in the face of expert concerns, NICE has approved limited use of Intrabeam for b​reast cancer patients. The College fully agrees that patient choice is paramount, but that choice should be informed, based on high level evidence. However, as we and others in the oncology community have repeatedly warned, we still await reliable evidence on the long-term effectiveness of Intrabeam and its potential to harm patients due to higher reported local cancer recurrence rates. Five-year follow-up on at least half of all trial patients is the nationally accepted gold standard for NHS commissioning, but these outcome data are still awaited.

“The NICE decision does recognise our concerns, although it frequently references the lack of follow-up data around local tumour recurrence in its documentation. Despite this, it has ruled in favour of limited Intrabeam use at centres already hosting the relevant machines.  

“In view of these ongoing concerns, we are confident our clinical oncology members and fellows will carefully consider and communicate the lack of robust evidence supporting this technique, should their patients ask for it.   

“Oncologists need to be open with their patients about the limits of the knowledge base around intrabeam. Centres implementing the guidance should have adequate support in place to allow patients being considered for Intrabeam therapy to jointly consult with both their surgeon and clinical oncologist, prior to deciding on therapy, to get an accurate and balanced overview of the potential risks involved.”

Read the full NICE decision and guidance

Read the RCR's previous statement on the development of the guidance