Lower GI 2017

Contact therapy - Conclusions

- Tumor < 3 cm: contact therapy is an alternative for surgery - T1 or early T2 (freely mobile) - No nodal involvement - Tumor > 3 cm: combination with EBRT (39 – 45 Gy) or interstitial brachytherapy (20 – 30 Gy) and close follow-up is needed - Local control 70 – 90 % - Toxicity is acceptable - Acute: 10 – 40%, mainly mucositis, no grade 3 – 4 toxicity - Late: mainly rectal bleeding or ulceration

-

TWO DRAWBACKS: - Diameter of the proctoscope determines the maximal size of the tumor that can be treated (max. 4 – 5 cm) - Rapid dose fall-off hampers treatment of tumors invading mesorectal fat

Gérard et al. Int J Radiat Oncol Biol Phys. 1996;34(4):775–83. Papillon et al. Int J Radiat Oncol Biol Phys. 1989;17(6):1161-9 Coatmeur et al. Radiother Oncol 2004;70(2):177–82. Aumock et al. Int J Radiat Oncol;51(2):363–70.