Current evidence on the efficacy and safety of selective internal radiation therapy (SIRT) for primary hepatocellular carcinoma is adequate for use with normal arrangements for clinical governance, consent and audit. Uncertainties remain about its comparative effectiveness, and clinicians are encouraged to enter eligible patients into trials comparing the procedure against other forms of treatment.
Patients with primary hepatocellular carcinoma should be selected for treatment by SIRT or for entry into trials by a multidisciplinary hepatobiliary cancer team.
SIRT should only be carried out by clinicians with specific training in its use and in techniques to minimise the risk of side effects from the procedure.
Clinicians should enter details about all patients undergoing SIRT for primary hepatocellular carcinoma onto the UK SIRT register. They should audit and review clinical outcomes locally and should document them and consider their relationship to patient characteristics.