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- Tumor < 3 cm: contact therapy is an alternative for surgery
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T1 or early T2 (freely mobile)
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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 %
Contact therapy - Conclusions
- Toxicity is acceptable
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Acute: 10 – 40%, mainly mucositis, no grade 3 – 4 toxicity
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Late: mainly rectal bleeding or ulceration
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TWO DRAWBACKS:
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Diameter of the proctoscope determines the maximal size of the tumor that can
be treated (max. 4 – 5 cm)
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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.