Contact Radiotherapy Offers New Organ-Preserving Approach for Rectal Cancer

The approach is linked to organ-preserving treatment strategies being developed by Tampere University and Tays.

HDR brachytherapy delivers radiation directly to the tumor through a device inserted into the rectum. The technique is designed to concentrate a high radiation dose at the tumor surface while limiting exposure to surrounding healthy tissue. The treatment uses an iridium-192 radiation source.

The approach is not suitable for every rectal cancer patient. Eligibility is assessed by a multidisciplinary team that includes colorectal surgeons, oncologists, radiation oncologists, and radiologists. One important group includes frail and older patients for whom major rectal cancer surgery may be especially burdensome or pose excessive risk.

The treatment is part of the NORPPA research program, which is coordinated by Tampere University and Tays. The research network includes hospitals across Finland and Estonia. The NORPPA-2 study is due to begin in 2027 and will examine the effectiveness of HDR brachytherapy as part of an organ-preserving treatment strategy for rectal cancer.

The study will assess whether intensified local radiotherapy can eradicate tumors and how many patients may avoid major surgery. If local radiotherapy proves sufficiently effective, researchers will also investigate whether some patients could be treated without chemotherapy. If the treatment is confirmed as effective and safe, it could expand the group of patients eligible for organ-preserving care instead of surgery.

“Curing cancer is always our primary goal, but we also want to preserve the best possible quality of life. If a tumor can be completely eradicated without removing the rectum, the patient may—in the best-case scenario—avoid both major surgery and a stoma,” said professor Toni Seppälä from Tampere University and Tays.

“The goal is not to treat the cancer less intensively, but more precisely. We want to identify a treatment that is sufficiently effective for each patient while avoiding treatments and side effects that would yield no additional benefit,” added Seppälä.

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