Clinical trials: UK HALO Radiofrequency Ablation Registry
UCLH is the lead UK centre for this Registry, which maps outcomes for patients undergoing this novel therapy to treat Barrett’s oesophagus. There are currently 26 hospitals around the UK and in the Republic of Ireland who are contributing to the Registry.
What is the HALO RFA?
HALO Radiofrequency ablation (RFA) is a new treatment, which uses radio waves to destroy the dysplasia (abnormal changes). It can also be used to treat the entire area of Barrett’s oesophagus. The treatment is given during an endoscopy procedure and patients go home the same day.
How is the procedure performed?
Patients are given a sedative and a tiny probe is then used to deliver the radio waves to heat and rapidly remove the affected parts. The procedure takes about 45 minutes. This treatment is usually repeated three or four times at intervals of two to three months until not only the dysplasia, but also the entire Barrett’s Oesophagus has been removed.
What can I expect during or after the procedure?
The outcomes of this treatment for dysplasia look promising. Approximately 80-90% of patients have reversal of the dysplasia at the end of the course of treatment, which usually takes a few months to complete. It is still a new treatment and doctors need to establish how long the benefits last. For this reason, all patients having the treatment need to have follow-up endoscopies long-term to ensure they remain well. We have set up the UK HALO Registry to monitor outcomes and are currently inviting all patients to join this study.
The risk of developing oesophageal ‘heartburn cancer’ is high for people with Barrett’s oesophagus and high-grade dysplasia (badly formed pre-cancerous cells), at about 10 % per year, with half of all patients developing cancer in around five years. This means that half of these people will NOT develop cancer in five years. This needs to influence your decision about whether or not to have treatment.
People with low-grade dysplasia have a risk that is rather lower, at around 5% per year.
All people with dysplasia arising in Barrett’s oesophagus should be referred to a specialist centre where their case is discussed by a multi- disciplinary team of doctors. Patients may then be referred for this treatment. All the major UK centres are part of the UK Registry and patients should therefore be invited to enter their information anonymously into the Registry. There are no special requirements for entering this study.
The study is being run nationally by Professor Laurence Lovat and Dr Rehan Haidry. There are lead investigators at every participating hospital.
Hospitals currently enrolled include:
University College London Hospital - Prof Lovat, Dr Haidry, Dr Banks, Dr Sweis
St Mary's Hospital, London - Dr Jonathan Hoare, Dr Natalie Direkze
Guy’s & St Thomas’ Hospital - Dr Jason Dunn
University Hospital Aintree - Dr Neil Kapoor
Royal Bournemouth and Christchurch Hospital - Dr Charles Gordon
Gloucestershire Royal Hospital - Prof Hugh Barr
Manchester Royal Infirmary - Dr Robert Willert
Queen Alexandra Hospital, Portsmouth - Dr Pradeep Bhandari
Royal Liverpool University Hospital - Dr Howard Smart, Dr Andrew Moore
Southampton University Hospital - Dr Praful Patel, Dr Phil Boger
Bradford Teaching Hospital - Dr Pradeep Mundre
Queen Elizabeth Hospital, Birmingham - Dr Brinder Mahon
Addenbrookes Hospital, Cambridge - Dr Fitzgerald, Massimiliano Di Pietro
Frimley Park Hospital - Dr Susannah Woodrow
Royal Wolverhampton Hospitals NHS - Dr Andrew Vietch
Norfolk & Norwich University Hospital - Mr Edward Cheong
Salford Royal NHS Foundation Trust - Dr Yeng Ang
Nottingham University Hospital NHS Trust - Prof Ragunath, Dr Ortiz Fernandez
County Durham & Darlington NHS Foundation Trust - Dr Anjan Dhar
Watford Hospital - Dr Anthony Leahy
Newcastle Hospitals - Dr David Nylander
John Radcliffe Hospital, Oxford - Dr Barbara Braden
Plymouth Hospital NHS Trust - Dr Sean Cochran
Broomfield Hospital, Chelmsford - Mr Venkatesh Jayanthi
Glasgow Royal Infirmary - Dr Grant Fullarton, Jonathan Morris
Royal Infirmary, Edinburgh - Dr Ian Penman
St James, Dublin - Mr Ravi, Dermot O'Toole
UK HALO RFA Registry: http://www.barretts-oesophagus.co.uk/
- For more information please contact Dr Rehan Haidry via Email: Rehan.Haidry@uclh.nhs.uk or Phone: 0203 447 7488