It is a revolution in the field of 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 Doctor Papillon, whose assistant I was, which is 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 reaches orbit, it’s the same feeling. »
90% of patients 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 then another international Opera [Organ Preservation in Early Rectal Adenocarcinoma] which began in 2014. This randomized trial takes eight years to show its effectiveness. It takes 140 patients, 70 who use the treatment and 70 who do not, then wait three years to be sure that it works. »
At the rate of 25 patients per year at the Nice center, we had to be patient. And the results speak for themselves: With conventional external radiotherapy, 60% of people in the trial were cured, and 90% of those who had benefited from Papillon 50 contact therapy sessions no longer had a tumour.
Only the tumor is irradiated
The machine, of which only three copies exist in France, comes with a tube that is placed inside the rectum. It is effective for tumors that do not exceed 5 cm in diameter and are, if possible, 3 cm or less. The Papillon 50 sends 20 gray of X-rays in two minutes, which corresponds to ten times more rays than in conventional radiotherapy.
“We control the irradiation, which means that only the tumor is affected and that it is absolutely not toxic”, specifies Professor Gérard. Only three five-minute sessions are necessary, then combined with five weeks of external radiotherapy. “In one session, 50% of the tumor is neutralized, in the second it’s 80%. In 99% of cases, the treatment goes as planned, without sequelae, without pain and above all without the risk of living with a disability that could have been caused by surgery,” he adds.
10% of cancers could benefit from this method
And the Papillon 50 doesn’t just treat rectal cancers. Skin cancers can also be treated in this way. “This machine could also be effective for the eyelids, mouth, vagina and all over the body on the surface. More than 10% of all cancers in France could benefit from this technique, indicates the professor who hopes for development throughout the country. It will then be necessary to provide more training because very few radiotherapists are able to handle this device which requires a difficult gesture. »
Dr Cyrielle Scouranec is one of those who know, in particular thanks to the transmission of knowledge from Pr Gérard. For a year, she has been practicing this method for patients. “There is a technical side with a challenge because you have to position yourself well to treat the tumor well,” she explains. From a medical point of view, it is very interesting and very satisfying to see the tumor respond to this treatment. »
At the Antoine-Lacassagne centre, another device, the Papillon+, is 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 delighted to be able to heal without surgery. »