Enhanced conformality in dose delivery and patient comfort for endorectal brachytherapy

Brachytherapy offers an exciting alternative to the significant toxicity and morbidity of current standard rectal cancer treatments. The intracavitary mould enables a highly conformal and effective endorectal treatment, as well as sparing of surrounding normal tissues to preserve the patient quality of life after the treatment.


Clinical Pedigree

The intracavitary mould has been developed to meet the standards of the high dose rate endorectal brachytherapy (HDREBT) protocol initiated in 1998 at the McGill University Health Center in Montreal, Canada by Dr. Te Vuong . This pre-operative protocol was developed as an alternative tumor downstaging and sphincter-preservation-surgery modality to reduce treatment-related toxicity associated to the standard treatment in a selected group of patients with locally advanced resectable rectal cancer.


Clinical Results

Demonstrated high rates of complete pathological response can be achieved with this technique, with significantly reduced toxicity levels and side effects for the patient , along with the benefits of a considerably shorter treatment time. The high tumor downstaging rate observed combined with the possible complete sparing of sphincter and surrounding healthy structures lead to a high sphincter preservation surgery rate, and does not increase postoperative complication rate . In inoperable patients with locally advanced rectal cancer, HDREBT administered as a boost after external beam radiation therapy has proven to be a tolerable treatment .


Effective, comfortable and efficient

The intracavitary mold has been designed to reach maximum endorectal treatment efficiency without compromising patient comfort and subsequent quality of life. The flexible and CT/MR compatible material can be bent gently to safely treat all rectum. Eight radial spaced treatment catheters just under the surface of the cylinder can be differentially loaded to ensure highly conformal target coverage while sparing healthy tissue.. The applicator is also compatible with commercially available rectal stand-off balloons. The central cavity can also accommodate central shielding to further optimize the sparing of uninvolved healthy tissues.


In conjunction with a suite of Nucletron solutions

Using Nucletron’s newest brachytherapy treatment planning solution, Oncentra® Brachy, in conjunction with the Intracavitary Mould ensures optimal tumor mapping and highly conformal dose planning. The Simulix® Evolution with Oncentra ConeBeam, with its 2D and 3D imaging, provides an easy way to achieve accurate reproducibility of the intracavitary mould placement. Its incorporation in the brachytherapy suite allows performing 3D image-guided brachytherapy, to easily verify applicator and patient positioning.


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Maximize your treatment options for endorectal brachytherapy


1. T Vuong et al, Conformal Pre-operative Endorectal Brachytherapy Treatment for Locally Advanced Rectal Cancer, Dis Colon Rectum 45 (2002) 1486-1495.
 2.  T Vuong et al, High Dose Rate Endorectal Brachytherapy as a Neoadjuvant Treatment for Patients with Resectable Rectal Cancer, Clin Oncol (R Coll Radiol) 19 (2007) 701-705.
3.  T Vuong et al, High Sphincter Preservation Rate for Patients with Low Rectal Cancer Treated with Neoadjuvant High Dose Rate Endorectal Brachytherapy, Int J Radiat Oncol Biol Phys 72 (2008) S132.
4. T Vuong et al, The use of High Dose Rate Endorectal Brachytherapy as a Boost in Inoperable Patients with Locally Advanced Rectal Tumors, Brachytherapy 7 (2008) 103.
5.  X Yan et al, Comparison of Dose Calculation Algorithms for Colorectal Cancer Brachytherapy Treatment with a Shielded Applicator, Med Phys 35 (2008) 4824-4830.