the tumor or tumors are surgically removed. In most cases, (part of) the rectum is also removed. Radiation therapy is an option, but usually very difficult to apply. The location of the tumor means that the radiation must be administered internally, ‘on the tumor’. There are only two locations in the Netherlands where this form of radiation, which is not only a very complex procedure but also very expensive, can be administered. Until now, because Maastrom a renowned Dutch radiotherapy center. has developed an innovative radiation device, the Maastro Rectal Applicator, together with Varian Medical Systems, which makes internal radiation of rectal carcinoma much easier and much more affordable.
The first patients have already been treated with the new rectal applicator in a clinical study at Maastro. The device has also already been approved and the first orders from clinics have already been placed, but Maastro wants to use these additional tests to test the safety and use again. This is also in view of the fact that radiologists who will be using the device in the future will have to be trained.
Accurate radiation
The Maastro Rectal Applicator is a form of internal – or contact – radiation, in which radiation is administered directly to the tumor. This is also called Brachytherapy. This spares the surrounding tissue and reduces the chance of side effects. The device can treat tumors up to 2.5 centimeters accurately with a high radiation dose, which increases the effectiveness of the treatment.
The invention by Maastro, in collaboration with Maastricht University, Varian (part of Siemens Healthineers) and SurgEase, means a breakthrough in the field of Brachytherapy in the Netherlands. Until now, this form of radiation was only possible with the aid of a very complex and expensive radiation device, which was called the ‘Butterfly’ among radiologists. There are only two of these in the whole of the Netherlands.
Two butterflies, many flowers?
The Maastro Rectal Applicator makes Brachytherapy a lot more accessible. During development, looking at the design of the device, the designers thought it looked like an inverted tulip. That is why the device was nicknamed 'Flower'. Hopefully, oncology (treatment) centers in the Netherlands will soon have a multitude of 'Flowers' in addition to the two 'Butterflies', so that this new form of treatment for rectal cancer will be accessible to all patients who can benefit from it.
In the fall of 2024, Maastro started a clinical study to confirm the practical feasibility of this new technique. The first patients have now been treated and Maastro expects to be able to present the results of this study at the end of 2025.
Evert van Limbergen, radiation oncologist, demonstrates the Maastro Rectal Applicator (Photo: Aron Nijs Photography)
"With the introduction of this new treatment method for rectal cancer, we are underlining our role as a top specialist center for radiotherapy. The definitive introduction of the MAASTRO rectal applicator will mean a breakthrough for patients with rectal cancer. Because the applicator is a relatively cheap and simple extension of existing brachytherapy equipment, we expect that the applicator will be widely used in other hospitals. Maastro expects that this will reduce the number of invasive operations, including the need for a permanent stoma,” said Maria Jacobs, chair of the Maastro board of directors.
