Rationale for EMIA Radiation Therapy

For cancer control, there is evidence that increasing radiation dose to the tumor will increase the likelihood of cure rate.

In order to achieve this objective, it is of utmost importance to spare normal tissues surrounding the tumor volume.

EMIA Radiation Therapy is the most adapted treatment, assisted by both imaging and endoscopic evaluation and adapted to tumor response. The treatment volume is highly targeted allowing sparing of  organs surrounding the tumor.

The treatment starts with external beam radiotherapy to cover potential nodal areas at risk as well as the tumor (standard of care). EMIA Radiation Therapy is then delivered to the residual tumor (tumor will shrink after external beam).

Boost Dose Distribution

Case 1

Patient with a mid-rectal cancer T3N1M0 tumor. He has numerous medical conditions that put him at high risk for surgical complications.

Magnetic Resonance Imaging
He received pre-operative chemotherapy (Xeloda in pills) and external beam radiation therapy to treat both lymph nodes at risk and to downsize the primary tumor. 
EMIAR Treatment
EMIAR treatment was given to the residual tumor.
Endoscopic History
3 years post-treatment, the patient is well and has no evidence of disease.

Case 2

Patient has an ultralow rectal tumor T2N0 invading a small portion of the anal canal.

MRI Images
He refused a permanent colostomy that is standard of care.
He first received 5 weeks of external beam radiotherapy and chemotherapy (Xeloda in pills) to treat nodes at risk and to downsize the tumor.
Endoscopic history
EMIART was then given to the residual tumor.
He is now 5 years after treatment, and has normal bowel function.