Clinical Oncology 2

Biological, physical and clinical aspects of treatment of cancer with ionising radiation

Principal investigators

Prof.Dr C.A.M. Marijnen, Dr C.L. Creutzberg, Dr A.D.G. Krol, Drs R.A. Nout, Prof.Dr E.M. Noordijk

Aim and focus

The department of Radiation Oncology is involved in translational and clinical research, aimed at the improvement of cancer treatment and quality of life.
The focus is primarily on initiation of and participation in large national and international clinical trials, and translational research and quality of life studies within the scope of these trials, such as studies on new molecular prognostic factors, decision making, long-term health related quality of life and long-term adverse effects.
Other major aims are clinico-pathologic studies of specific rare malignancies, such as cutaneous lymphomas, choroidal melanomas, and bone and soft tissue sarcomas, for which the department is a national or regional referral center.  

Position in international context

The principal investigators are initiators and coordinators of several national and international studies, such as the International rectal cancer study (TME study), the PORTEC-1, -2 and -3 trials on endometrial carcinoma and the EORTC Hodgkin H7 and H9 trials. The department has played a coordinating role in several other large national randomized trials. The investigators have leading roles in national and international collaboration networks, especially national (DCCG) and international rectal cancer groups, international (IGCS Council, GCIG, Uterine Task force of NCI) and national gynaecologic cancer groups (LPRGT, DGOG), and have received major grants for further research.
There is active participation in a nationwide late outcome network after treatment for Hodgkin lymphoma.   

Content/highlights/achievements

The scientific production from the rectal carcinoma trial has been very successful. The preoperative radiation scheme has become the standard for rectal carcinoma. The PORTEC trials have defined the role of radiation therapy in endometrial cancer and have had major impact on international treatment guidelines. The PORTEC-3 trial has attracted international participation from major research groups. The bone metastasis trial has made ‘1x8 Gy’ the treatment of choice. Limits of minimal radiotherapy have been set for Hodgkin lymphoma. These trials have led to many side studies, major publications and theses.

Future themes

• Translational research studies of genome profiling and new prognostic factors on rectal cancer
• Decision making studies and quality of life studies on rectal cancer
• Coordination of the international PORTEC-3 trial, in collaboration with Cancer Research UK (NCRI), NCIC-CTG (Canada), ANZGOG (Australia and New Zealand), GCIG and other groups; pathology review; side studies
• Clinical, pathologic and quality of life research in the PORTEC-2 trial
• Cancer survivorship investigations in the PORTEC-1 and -2 trials
• Study on late effects of treatment of Hodgkin and non-Hodgkin lymphomas.
• Retrospective studies and translational research of bone and soft tissue sarcomas.
• Prospective and retrospective studies on cutaneous lymphoma and choroidal melanoma.
• Participation in other clinical trials, such as the EORTC H10 trial, the retreatment of bone metastases study, etc.

Cohesion within LUMC

The research is conducted in strong collaboration with the departments of Surgical Oncology, Pathology, Statistics, Medical Decision making, Haematology, Orthopaedic Surgery, Dermatology, Gynaecologic Oncology, Radiology, and Medical Oncology.

Key publications

Nout RA, Putter H, Jurgenliemk-Schulz IM, Jobsen JJ, Lutgens LC, van der Steen-Banasik EM, Mens JW, Slot A, Stenfert Kroese MC, van Bunningen BN, Smit VT, Nijman HW, van den Tol PP and Creutzberg CL. Quality of Life After Pelvic Radiotherapy or Vaginal Brachytherapy for Endometrial Cancer: First Results of the Randomized PORTEC-2 Trial. J Clin Oncol 2009 (Epub ahead of print, June 22, 2009 as 10.1200/JCO.2008.20.2424).
IF 15.5

De Bruin ML, Dorresteijn LD, van't Veer MB, Krol AD, van der Pal HJ, Kappelle AC, Boogerd W, Aleman BM and van Leeuwen FE. Increased risk of stroke and transient ischemic attack in 5-year survivors of Hodgkin lymphoma. J Natl Cancer Inst 2009 101:928-937.
IF 15.7

Noordijk EM, Carde P, Dupouy N, Hagenbeek A, Krol AD, Kluin-Nelemans JC, Tirelli U, Monconduit M, Thomas J, Eghbali H, Aleman BM, Bosq J, Vovk M, Verschueren TA, Peny AM, Girinsky T, Raemaekers JM and Henry-Amar M. Combined-modality therapy for clinical stage I or II Hodgkin's lymphoma: long-term results of the European Organisation for Research and Treatment of Cancer H7 randomized controlled trials. J Clin Oncol 2006 24:3128-3135.
IF 15.5

Marijnen CA, van d, V, Putter H, van den BM, Maas CP, Martijn H, Rutten HJ, Wiggers T, Kranenbarg EK, Leer JW and Stiggelbout AM. Impact of short-term preoperative radiotherapy on health-related quality of life and sexual functioning in primary rectal cancer: report of a multicenter randomized trial. J Clin Oncol 2005 23:1847-1858.
IF 15.5

Creutzberg CL. Lymphadenectomy in apparent early-stage endometrial carcinoma: do numbers count? Editorial J Clin Oncol 2005 23:3653-3655.
IF 15.5

Creutzberg CL, van Putten WL, Warlam-Rodenhuis CC, van den Bergh AC, De Winter KA, Koper PC, Lybeert ML, Slot A, Lutgens LC, Stenfert Kroese MC, Beerman H and van Lent M. Outcome of high-risk stage IC, grade 3, compared with stage I endometrial carcinoma patients: the Postoperative Radiation Therapy in Endometrial Carcinoma Trial. J Clin Oncol 2004 22:1234-1241.
IF 15.5

Marijnen CA, Kapiteijn E, van d, V, Martijn H, Steup WH, Wiggers T, Kranenbarg EK and Leer JW. Acute side effects and complications after short-term preoperative radiotherapy combined with total mesorectal excision in primary rectal cancer: report of a multicenter randomized trial. J Clin Oncol 2002 20:817-825.
IF 15.5

Marijnen CA, Nagtegaal ID, Klein KE, Hermans J, van de Velde C, Leer JW and van Krieken JH. No downstaging after short-term preoperative radiotherapy in rectal cancer patients. J Clin Oncol 2001 19:1976-1984.
IF 15.5

Kapiteijn E, Marijnen CA, Nagtegaal ID, Putter H, Steup WH, Wiggers T, Rutten HJ, Pahlman L, Glimelius B, van Krieken JH, Leer JW and van de Velde C. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer. N Engl J Med 2001 345:638-646.
IF 52.6

Creutzberg CL, van Putten WL, Koper PC, Lybeert ML, Jobsen JJ, Warlam-Rodenhuis CC, De Winter KA, Lutgens LC, van den Bergh AC, van de Steen-Banasik, Beerman H and van Lent M. Surgery and postoperative radiotherapy versus surgery alone for patients with stage-1 endometrial carcinoma: multicentre randomised trial. PORTEC Study Group. Post Operative Radiation Therapy in Endometrial Carcinoma. Lancet 2000 355:1404-1411.
IF 28.6