Selective internal radiation therapy for colorectal metastases in the liver

Summary

The National Institute for Health and Clinical Excellence (NICE) issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on selective internal radiation therapy for colorectal metastases in the liver in September 2004.

NICE has reviewed this guidance and is reassessing the procedure. New guidance will be published as a result.  Until the new guidance is published the NHS should continue to follow the recommendations in the guidance below.

If you wish to be updated to any developments with this procedure, you can express an interest here.

 

Description

Colorectal cancer arises in the colon or rectum. It is the second most common cancer in women and the third most common cancer in men in the UK. Around 50% of colorectal cancer patients will develop recurrence within 5 years of initial diagnosis, with the liver being the most common site for metastatic disease. Selective internal radiation therapy (SIRT) is used to treat non-resectable hepatic metastases secondary to colorectal cancer, usually in combination with hepatic arterial chemotherapy.

The standard method of treatment for patients with liver metastases from colorectal cancer is surgical resection, but fewer than 10% of patients are suitable for operation. For patients with non-resectable hepatic metastases, treatment options include systematic chemotherapy, radiotherapy, cryotherapy, alcohol injection and laser photocoagulation.

Radioactive spheres are injected using a syringe into the hepatic artery via a trans-femoral catheter or a permanently implanted port with a catheter to the hepatic artery. For the placement of this access port patients may need to undergo a laparotomy.

OPCS code:

J12.3 Selective internal radiotherapy with microspheres to lesion of liver

X65.3 Delivery of a fraction of interstitial radiotherapy 

Y36.4 Introduction of non-removable radioactive substance into organ for brachytherapy NOC

Y53.4 Approach to organ under fluoroscopic control

In addition the ICD-10 code C78.7 Secondary malignant neoplasm of liver would be recorded.

_{The NHS Classifications Service of NHS Connecting for Health is the central definitive source for clinical coding guidance and determines the coding standards associated with the classifications (OPCS-4 and ICD-10) to be used across the NHS.   The NHS Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided.  www.connectingforhealth.co.uk/clinicalcoding}

Details

Contact details:

Links:

	Selective internal radiation therapy for colorectal metastases in the liver (interventional procedures consultation)	20 October 2009
	Selective internal radiation therapy for colorectal metastases in the liver (interventional procedures overview)	20 October 2009
	IPG93 Selective internal radiation therapy for colorectal metastases of the liver: guidance	22 September 2004
	IPG93 Selective internal radiation therapy for colorectal metastases of the liver: understanding NICE guidance	22 September 2004
	IPG93 Ymbelydriad mewnol detholiadol ar gyfer metastasau colorefrol yn yr afu/iau: deall canllawiau NICE	03 February 2009
	IPG93 Selective internal radiation therapy for colorectal metastases of the liver: distribution list	22 September 2004
	Interventional procedure consultation document - selective internal radiation therapy for colorectal liver metastases	30 December 2003
	Overview of selective internal radiation therapy for colorectal metastases of the liver	30 December 2003