Rectal and anal GEC ESTRO sub group was initially set up mainly to promote brachytherapy in rectal and anal cancer. However, 2018 our group was extended to include the whole of GI tract as it was felt that there is a need to promote brachytherapy in other GI sites such as oesophagus, liver and biliary tract.

  • To stimulate the revival of interest in GI brachytherapy.
  • To establish the role of brachytherapy in GI cancers.
  • To organise multicentre Phase 2 and 3 clinical trials.
  • To organise training courses in brachytherapy.
  • To set up a database for GI cancer brachytherapy.  
  • There is an annual Papillon training course at Clatterbridge every October since 2010 to train clinician interested in contact X-ray brachytherapy (Papillon) for rectal cancer. This year course is on 1st and 2nd of October (2019). Those interested to attend please contact Prof Sun Myint.
  • The Royal College of Radiologists runs brachytherapy courses annually which includes GI brachytherapy. There are no courses planned for this year.
  • The scientific meetings are organised by International Contact Radiotherapy network (ICONE) under the auspices of GEC ESTRO on Saturday morning during annual ESTRO meetings. Next year meeting is on 4th April 2020 in Vienna.
  • GI GEC group meetings are held a day before annually GEC ESTRO workshops for half a day from midday. This year the meeting will be on 21st November 2019 from 13.00-16.30 in Budapest.
  • CONTEM 1- This study was set up to evaluate the role of post-operative CXB in pT1 cN0cM0 following local surgical excision for early rectal cancer cT1 (<2cm) in patients not suitable for surgery or in patients refusing surgery.
  • CONTEM 2- This study was set up to evaluate the role of CXB boost in more advanced cT2 cN0 tumours (>2cm) in surgically fit patients refusing surgery for residual disease following external beam chemo-radiotherapy (EBCRT) or external beam radiotherapy (EBRT).  Residual tumour <2cm can be offered TEMS after EBCRT and CXB.
  • CONTEM 3 - This study was set up to evaluate the role of CXB boost in more advanced cT3 (any size) cN1/N2 in patient who are not suitable for surgery with residual tumour following EBRT or SCRT.
  • OPERA (clinical NCT02505750) – This is an ongoing phase 3 multi-centred European randomised trial set up to evaluate the role of CXB boost following EBCRT. The randomisation is between EBRT boost and CXB boost following EBCRT for cT2cT3a /cN0 cN1 <5cm. The end point is organ preservation at 3 years. The trial started in June 2015 and is recruiting well. We have now randomised 116 patients, so far.

National data base for early rectal cancer treated by CXB was set up at Guildford at the request of NICE (National Institute for Health and Care Excellence) since 2016. We hope to include data for more advanced rectal cancers treated by CXB and HDR brachytherapy.

Chair: Arthur Sun Myint, Liverpool, UK

K. Bujko, Warsaw, PL

A. Dhadda, Hull, UK

Maria Antonietta Gambacorta, Rome, IT

Jean Pierre Gerard , Nice, FR

Peter Hass, Magdeburg, DE

Anders Jakobsen, Vilef, DK

A. R. Jensen, Aarhus, DK

Jacob Lindegaard, Aarhus, DK

Alex McDonald, Glasgow, UK

C. A. M. Marijnen, Amsterdam, NL

Jamie Mills, Nottingham, UK

Robert Myerson, St Louis, USA

Remi Nout, Leiden, NL

Carlin Radu, Uppsala, SE

V.S. Ramani, Brisbane, AU

R. Schmidt, Vienna, AT

Karen-Lise Garm Spindler, Aarhus, DK

Raj Sripadam, Clatterbridge, UK

Alex Stewart , Guildford, UK

Diana Tait, London, UK

Veronique Vendrely , Bordeaux, FR

Karen Whitmarsh, Clatterbridge, UK

  • Smith F, Pritchard DM, Sun Myint A et al. A cohort study of local excision followed by adjuvant therapy incorporating a contact X-ray brachytherapy boost instead of radical resection in 180 patients with rectal cancer. Colorectal Disease 2019; Colorectal Dis. 2019; 21(6):663-670.             doi: 10.1111/codi.14584.
  • Sun Myint A, Smith FM, Gollins S et al. Dose Escalation Using Contact X-ray Brachytherapy After External Beam Radiotherapy as Nonsurgical Treatment Option for Rectal Cancer: outcomes From a Single-Center Experience. Int J Radiat Oncol Biol Phys 2018; 100: 565–73 doi: 10.1016/j.ijrobp.2017.10.022.
  • Sun Myint A, Smith F, Gollins S et al. Dose escalation using contact X-ray brachytherapy (Papillon) for rectal cancer: Does it improve the chance of organ preservation? B J Radiology (2017); 90: 2017017
  • Low energy contact X ray brachytherapy (the Papillon technique) for early stage rectal cancer NICE 2015 (IPG 532)
  • Dhadda AS, Martin A, Killeen S, Hunter IA. et al. Organ preservation using contact radiotherapy for early rectal cancer: Outcomes of patients treated at a single centre in the UK. Clin Oncol 2017; 29:198–204.
  • Frin AC, Evesque L, Gal J, Benezery K, Francois E, Gugenheim J, et al. Organ or sphincter preservation for rectal cancer. The role of contact X-ray brachytherapy in a monocentric series of 112 patients. Eur J Cancer 2017; 72: 124–36.
  • European phase III study comparing a radiation dose escalation using 2 different approaches: External beam radiation therapy versus endocavitary radiation therapy with contact x-ray brachytherapy 50 kilovolts (kV) for patients with rectal adenocarcinoma. ID: NCT02505750.
  • Rao C, Smith F, Martin AP. A Cost-Effectiveness Analysis of Contact X-ray Brachytherapy for the Treatment of Patients with Rectal Cancer Following a Partial Response to Chemoradiotherapy. Clinical Oncology 2017
  • Gerard JP, Sun Myint A, Croce O, et al. Renaissance of contact X-ray therapy for treating rectal cancer Expert Review Medical Devices 2011:8: 483-492.
  • Sun Myint A, Lee C.D., Hoskin P.  -Rectal Brachytherapy (Book Chapter).Radiotherapy in practice Brachytherapy (Second Edition) 2011. Oxford University Press.
  • Sun Myint A, Lee C.D and Gerard J P Rectal cancer (Chapter 25) GEC ESTRO brachytherapy handbook. Part II Clinical Practice. Second edition. GEC ESTRO publication.
  • Sun Myint A, Gerard JP and Myerson RJ Contact X-ray brachytherapy for rectal cancer (Book chapter 8) Modern Management of Cancer of the Rectum. Editors Walter E. Longo, Vikram Reddy and Riccardo A. Audisio. Springer. ISBN 978-1-6608-5/ ISBN 978-1-4471-6609-2 (eBook) 2015.

If you are interested in any of our activities and would like to join the group please contact: Prof Arthur Sun Myint