Guidance
3 Committee considerations
The evidence
3.1 NICE did a rapid review of the published literature on the efficacy and safety of this procedure. This comprised a comprehensive literature search and detailed review of the evidence from 7 sources, which was discussed by the committee. The evidence included 2 systematic reviews and meta-analyses, 4 case series and 1 cohort study. It is presented in the summary of key evidence section in the interventional procedures overview. Other relevant literature is in the appendix of the overview.
3.2 The professional experts and the committee considered the key efficacy outcomes to be: local recurrence, disease-free survival, overall survival and quality of life.
3.3 The professional experts and the committee considered the key safety outcomes to be: damage to adjacent structures in the short and long term, including ureteric strictures, wound complications and bony necrosis.
3.4 The committee received and discussed 2 commentaries from a representative of patients who had experience of this procedure.
Committee comments
3.5 The committee was informed that this is a complex procedure that requires a multidisciplinary team, as detailed in section 1.3, in addition to theatre staff trained to undertake this procedure.
3.6 The committee was informed that this procedure requires highly specialist equipment to deliver the radiotherapy, and specialist shielding in the operating theatre.
3.7 Most of the evidence came from people with rectal cancer.
3.8 The committee was informed that this procedure can reduce the extent of surgery needed.
ISBN: 978-1-4731-5222-9