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.
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 NICE's information for the public is recommended.
Audit and review clinical outcomes of all patients having PDT for early-stage oesophageal cancer (see NICE's interventional procedures guidance audit tool template).
Further research will be useful, and clinicians are encouraged to enter patients into well-designed trials and to collect longer-term follow-up data. NICE may review the procedure upon publication of further evidence.