S24
Brachytherapy - Gastro-intestinal, paediatric brachytherapy, miscellaneous
ESTRO 2026
References: 1. Bellezzo M, Fonseca GP, Voncken R, Verrijssen AS, Van Beveren C, Roelofs E, et al. Advanced design, simulation, and dosimetry of a novel rectal applicator for contact brachytherapy with a conventional HDR (192)Ir source. Brachytherapy. 2020;19(4):544-53.2. Gerard JP, Barbet N, Schiappa R, Magne N, Martel I, Mineur L, et al. Neoadjuvant chemoradiotherapy with radiation dose escalation with contact x-ray brachytherapy boost or external beam radiotherapy boost for organ preservation in early cT2-cT3 rectal adenocarcinoma (OPERA): a phase 3, randomised controlled trial. Lancet Gastroenterol Hepatol. 2023;8(4):356-67.
(CRT) or short-course radiotherapy (SCRT) [3]. Inoperable patients, patients not suitable for CRT or patients with incomplete response or tumor regrowth after neoadjuvant chemoradiotherapy were offered CXB+SCRT treatments outside of the trial according to GEC ESTRO ACROP recommendations [4]. Results: From March to November 2025, sixteen patients (median age 62) were included in the CORRECT trial. Another ten patients (median age 79) received treatment outside of the trial. By November 7th, 2025, nine consecutive patients on the trial were evaluated with digital rectal examination (DRE), magnetic resonance imaging (MRI) and sigmoideoscopy at 3 months after the treatment start. Among these, four patients were evaluated twice, at 3 and 6 months. Complete clinical response (cCR) or near-complete clinical response (ncCR), both radiologically and endoscopically, was demonstrated in 8 (89%) of the patients and further follow-up is continuous. Conclusion: During the first eight months since clinical implementation, a total of twenty-six patients have been treated with CXB in Stockholm, Sweden. According to the International Contact Radiotherapy Network (ICONE), this represents the fastest ramp-up of CXB sites internationally. Our initial cCR or ncCR rate of 89% is satisfactory and consistent with previously published results. The efficacy of CXB+SCRT is being compared to CXB+CRT in the ongoing CORRECT trial. Keywords: papillon, contact radiotherapy, rectal cancer References: 1. Habr-Gama, A., et al., Increasing the rates of complete response to neoadjuvant chemoradiotherapy for distal rectal cancer. Dis Colon Rectum, 2009. 52(12): p. 1927–34.2. Baron, D., et al., 5 year results of the OPERA trial. Ann Oncol, 2024. 36(2):208-2153. Nilsson, P.J., et al., Contact radiotherapy for rectal cancer (CORRECT): study protocol for a multicentre randomised phase II trial. BMJ Open, 2025. 15(4): e1003564. Stewart, A.J., et al., GEC ESTRO ACROP consensus recommendations for contact brachytherapy for rectal cancer. Clin Transl Radiat Oncol, 2022. 33: p. 15–22.
Digital Poster 2887
Clinical implementation of contact x-ray brachytherapy (CXB) for rectal cancer in Stockholm, Sweden
Alexander Valdman 1,2 , Masoud Karimi 3,2 , Joanna Östling Palme 3 , Sara Bornedal 4 , Maria H Persson 4 , Annika Sjövall 5,6 , Richard Marsk 5,6 , Per J Nilsson 5,6 1 Department of Radiation Oncology, Karolinska University Hospital, Stockholm, Sweden. 2 Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden. 3 Department of Gastrointestinal Oncology, Karolinska University Hospital, Stockholm, Sweden. 4 Department of Radiotherapy Physics and Engineering, Karolinska University Hospital, Stockholm, Sweden. 5 Department of Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden. 6 Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden Purpose/Objective: There is a growing clinical and research interest in non-operative management of early-stage rectal cancer [1], which is also becoming an appealing treatment option for selective patients [2]. The purpose of this project was to implement an organ- sparing alternative to TME surgery for patients with early-to-intermediate rectal cancer in Stockholm, Sweden. Material/Methods: The machine (Papillon+ Ariane Medical Systems Ltd) for delivering contact x-ray brachytherapy (CXB) was successfully installed in Stockholm, Sweden in February 2025. Operable patients with cT1–cT3ab rectal cancer measuring <5 cm in largest diameter, involving <50% of the rectal circumference, N0–N1 ( ≤ 3 nodes <8 mm in diameter), localised ≤ 10 cm from the anal verge, were offered participation in the Swedish national multicenter randomised phase II clinical trial CORRECT (NCT06501053), which aims to compare the combination of CXB with either chemoradiotherapy
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