TY - JOUR
T1 - Clinical applications of high dose rate endorectal brachytherapy for patients with rectal cancer
AU - Vuong, T.
AU - Garant, A.
AU - Vendrely, V.
AU - Martin, A. G.
AU - Devic, S.
N1 - Publisher Copyright:
© 2022 Société française de radiothérapie oncologique (SFRO)
PY - 2022/10
Y1 - 2022/10
N2 - With the establishment of total mesorectal excision for the treatment of rectal cancer, local recurrence rates have significantly decreased. The addition of preoperative external beam irradiation further reduces this risk to less than 6%. As the local treatment becomes successful and more widely used, the associated treatment-related toxicity is becoming clinically important. If 4 to 6% of the patients are to benefit from neo-adjuvant therapy before total mesorectal excision, the acute and the long-term toxicity burden must be reasonable. With the introduction of better-quality imaging for tumour visualization and treatment planning, a new-targeted radiation treatment was introduced with high dose rate endorectal brachytherapy. The treatment concept was tested in phase I and II studies first in the preoperative setting, then as a boost after external beam radiation therapy as a dose escalation study to achieve higher tumour local control in a radical treatment setting with no surgery. High dose rate endorectal brachytherapy is safe and effective in achieving high tumour regression rate and was well tolerated. It is presently explored in a phase III dose escalation study in the non-operative management of patients with operable rectal cancer.
AB - With the establishment of total mesorectal excision for the treatment of rectal cancer, local recurrence rates have significantly decreased. The addition of preoperative external beam irradiation further reduces this risk to less than 6%. As the local treatment becomes successful and more widely used, the associated treatment-related toxicity is becoming clinically important. If 4 to 6% of the patients are to benefit from neo-adjuvant therapy before total mesorectal excision, the acute and the long-term toxicity burden must be reasonable. With the introduction of better-quality imaging for tumour visualization and treatment planning, a new-targeted radiation treatment was introduced with high dose rate endorectal brachytherapy. The treatment concept was tested in phase I and II studies first in the preoperative setting, then as a boost after external beam radiation therapy as a dose escalation study to achieve higher tumour local control in a radical treatment setting with no surgery. High dose rate endorectal brachytherapy is safe and effective in achieving high tumour regression rate and was well tolerated. It is presently explored in a phase III dose escalation study in the non-operative management of patients with operable rectal cancer.
KW - Non-operative management of rectal cancer
KW - Rectal brachytherapy
KW - Targeted therapy for rectal cancer
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U2 - 10.1016/j.canrad.2022.07.001
DO - 10.1016/j.canrad.2022.07.001
M3 - Review article
C2 - 36031497
AN - SCOPUS:85137773651
SN - 1278-3218
VL - 26
SP - 879
EP - 883
JO - Cancer/Radiotherapie
JF - Cancer/Radiotherapie
IS - 6-7
ER -