Cost regulators for National Health Service treatments in England and Wales are backing controlled use of targeted breast cancer radiotherapy treatment alongside further research.
The National Institute for Health and Care Excellence has published draft guidance recommending the Intrabeam Radiotherapy System (Carl Zeiss UK) as an option for patients with early forms of the disease.
The Committee highlighted uncertainty over whether the technology is as effective as conventional radiotherapy in preventing recurrence of the disease, but said it heard the risk of local recurrence is low in the patients and that people may be prepared to accept a level of uncertainty in order to avoid having to have radiotherapy after their surgery.
Because of this, the Committee has also recommended that patients are given information on the treatment options available, including their associated risks and benefits so that they can make an informed choice.
With Intrabeam only one 30 minute dose is required and it is given at the same time as surgery to remove the tumour, eliminating the need for multiple hospital visits for most patients. According to one patient expert, this would be considered a major advantage and might counter the fact that much less is known about the long-term outcomes of the treatment versus conventional radiotherapy, which typically requires numerous doses over a three-week period weeks after surgery when the wounds have healed.
Clinical trials for Intrabeam have been conducted in some centres in the UK and that some machines are already available. But each machine costs £435,000 to buy and £35,000 a year to maintain, so the Committee was keen to emphasise the importance of using the existing machines as effectively as possible.
Over 50,000 women and around 340 men are diagnosed with breast cancer each year in the UK, of which around 86 percent of could potentially have early forms of the disease.
“This is a promising new way of providing radiotherapy but the evidence needs to develop and the committee therefore recommended that its use is carefully controlled and accompanied by gathering additional information on its clinical effectiveness,” said Professor Carole Longson MBE, director of the centre for health technology evaluation at NICE.
