A critical review of the evidence identified consensus referral criteria and outcome data against which to audit patients. Results: Referral criteria were derived from six published studies. These applied to patients unfit for surgery or stoma-averse. All referred patients had a visible tumour or scar with a tumour size under 3cm and sited less than 12cm from the anal verge. Nodal status varied from N0 to N2 but there was no metastatic disease present. The audited cohort demonstrated equivalence of median age, performance status, and tumour stage. Initial clinical complete response (cCR), local recurrence, and occurrence of distant metastases were also comparable. Conclusion and Discussion: Similarity of cohort demographics enabled comparison of outcome data which confirmed the validity of referral and treatment protocols. Although the limited evidence base and retrospective nature of the audit limits the strength of the findings, until evidence from ongoing studies becomes available this work should guide future referrals in the interim and contribute to development of robust national guidelines. Numerical References 1. Myint, A.S. (2017) Do patients have a choice? Oncology News.12(1), 4-6; 2. National Institute for Health and Care Excellence. (2015) Low energy contact x-ray brachytherapy (the Papillon technique) for early stage rectal cancer. NICE Interventional procedures guidance (IPG532); NICE: London
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