It is a revolution in medicine and in the fight against cancer. At the Antoine-Lacassagne Center in Nice, the Papillon 50 contact therapy device has just been scientifically recognized at the Asco (Society of Clinical Oncology) congress in Chicago as an effective treatment for rectal cancer.
“I treated my first patient in Lyon 50 years ago with this method, learned from Dr Papillon, whose assistant I was, that’s why the device has this name today, develops Professor Jean-Pierre Gérard, radiotherapist at the center for the fight against cancer in Nice , at the initiative of the research. This recognition is like when you send a rocket to the moon and it comes into orbit around the earth, it’s the same feeling.”
90% of patients are cured thanks to the Papillon 50 in addition to external radiotherapy
“This is the first time that we can cure small rectal cancers without surgery,” he continues. The method fell into oblivion in the 1990s and it is an expensive device. Philipps, who took care of the production, stopped in the 2000s. I then did a first study in 2004 and then another International Opera [Organ Preservation in Early Rectal Adenocarcinoma] which started in 2014. This randomized trial will take eight years to demonstrate its effectiveness. It takes 140 patients, 70 who use the treatment and 70 who don’t, and then wait three years to make sure it works. †
At a rate of 25 patients a year in the center of Nice, we had to be patient. And the results speak for themselves: With conventional external radiotherapy, 60% of the people in the study were cured, and 90% of those who benefited from Papillon 50 contact therapy sessions had no more tumors.
Only the tumor is irradiated
The machine, of which there are only three copies in France, comes with a tube that is placed in the rectum. It is effective for tumors no larger than 5 cm in diameter and, if possible, 3 cm or less. The Papillon 50 emits 20 gray X-rays in two minutes, which corresponds to ten times more rays than with conventional radiotherapy.
“We control the radiation, which means that only the tumor is affected and is absolutely non-toxic,” explains Professor Gérard. Only three five-minute sessions are needed, then combined with five weeks of external radiotherapy. “In one session, 50% of the tumor is neutralized, in the second it is 80%. In 99% of cases, the treatment goes as planned, without consequences, without pain and above all without the risk of living with a disability that could be caused by surgery,” he adds.
10% of cancers could benefit from this method
And the Papillon 50 doesn’t just treat rectal cancers. Skin cancer can also be treated in this way. “This machine can also be effective for the eyelids, mouth, vagina and the whole body on the surface. More than 10% of all cancers in France could benefit from this technique, says the professor who hopes for development throughout the whole world.” It will then be necessary to provide more training because very few radiotherapists can handle this device which requires a difficult gesture.”
Dr Cyrielle Scouranec is one of those who know, thanks in particular to Pr Gérard’s knowledge transfer. She has been practicing this method for patients for a year now. “There is a technical side to a challenge, because you have to position yourself well to treat the tumor properly,” she explains. From a medical point of view, it is very interesting and very satisfying to see how the tumor responds to this treatment. †
In the center of Antoine-Lacassagne is another device, the Papillon+, this time unique in the world. “It can cure breast cancer in one day, in one minute,” says Jean-Pierre Gérard. It’s a revolution because we change the rest of the patients’ lives, they are happy that they can heal without surgery. †