At our institution, high dose rate brachytherapy has been used since 1998 as a pre-operative radiation modality and more than 1200 patients have been treated with very favorable oncological outcomes when compared to matched pair control (Breugom et al. 2015). This modality is offered to patients with stage II and early stage III (N1) rectal cancer as a treatment option to standard chemotherapy and external beam radiotherapy versus short-course pelvic external beam radiotherapy. It is a solution for patients who have received previous pelvic radiation and need tumor downstaging prior to surgery.

Currently, our team is developing a novel applicator for treatment of rectal cancer equipped with a radiation shield that rotates during the treatment, delivering a high dose to the tumor through its emission window to increase the cure rates while shielding radiation sensitive surrounding healthy tissue to decrease the side effects of radiation. We are also developing a comprehensive treatment planning software consisting of accurate dose calculation methods and optimization algorithms to calculate and plan a more accurate dose to the tumor and surrounding healthy tissues. Artificial Intelligence methods are under development for accurate tumor segmentation and treatment outcome prediction.