NICE interventional procedure guidance
Issued: July 2013

Selective internal radiation therapy for primary intrahepatic cholangiocarcinoma

This is an extract from the guidance. The complete guidance is available at

1 Guidance

1.1 Current evidence on the safety and efficacy of selective internal radiation therapy (SIRT) for primary intrahepatic cholangiocarcinoma is limited in both quantity and quality. Therefore this procedure should only be used with special arrangements for clinical governance, consent and audit or research.

1.2 Clinicians wishing to undertake SIRT for primary intrahepatic cholangiocarcinoma should take the following actions.

  • Inform the clinical governance leads in their Trusts.

  • Ensure that patients understand the uncertainty about the procedure's safety and efficacy, and provide them with clear written information. In addition, the use of NICE's information for the public is recommended.

1.3 Patients with primary intrahepatic cholangiocarcinoma should be selected for treatment by SIRT or for entry into trials by a multidisciplinary hepatobiliary cancer team.

1.4 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.

1.5 Clinicians should enter details about all patients undergoing SIRT for primary intrahepatic cholangiocarcinoma onto the UK SIRT register. They should audit and review clinical outcomes locally and should document them and consider their relationship to patient characteristics.

1.6 NICE encourages research to guide future use of SIRT for primary intrahepatic cholangiocarcinoma. This should document patient characteristics, tumour response, survival and quality of life measures, and details of other treatments used adjunctively or sequentially. NICE may review the procedure on publication of further evidence.