Gynaecological Cancers - improving treatment, risk prediction and rehabilitation
Research on Endometrial Cancer
The PORTEC-trials have focused on improving adjuvant radiotherapy for women with endometrial cancer, reducing their treatment burden by better selection for adjuvant treatment and less toxic treatments, such as replacing external beam radiotherapy by short-course vaginal brachytherapy for those with (high) intermediate risk disease). The PORTEC-3 trial has established the role and impact in terms of toxicity and health-related quality of life of adjuvant radiotherapy combined with adjuvant chemotherapy for women with high-risk endometrial cancer. The translational research collaboration with the LUMC Dept of Pathology (Prof. T. Bosse, prof V.T.H.B.M. Smit) has evolved into an internationally renowned innovative translational research group contributing to new knowledge of risk factors, treatment targets and especially the translational work on the PORTEC-3 trial tissues has led to new knowledge on prognostic and predictic molecular factors, better identifying subgroup who would benefit from specific new treatment approaches.
…Research on Endometrial Cancer
The PORTEC-trials have focused on improving adjuvant radiotherapy for women with endometrial cancer, reducing their treatment burden by better selection for adjuvant treatment and less toxic treatments, such as replacing external beam radiotherapy by short-course vaginal brachytherapy for those with (high) intermediate risk disease). The PORTEC-3 trial has established the role and impact in terms of toxicity and health-related quality of life of adjuvant radiotherapy combined with adjuvant chemotherapy for women with high-risk endometrial cancer. The translational research collaboration with the LUMC Dept of Pathology (Prof. T. Bosse, prof V.T.H.B.M. Smit) has evolved into an internationally renowned innovative translational research group contributing to new knowledge of risk factors, treatment targets and especially the translational work on the PORTEC-3 trial tissues has led to new knowledge on prognostic and predictic molecular factors, better identifying subgroup who would benefit from specific new treatment approaches.
The PORTEC-4a trial, the first worldwide to investigate molecular profile-guided adjuvant treatment for patients with high-intermediate risk endometrial cancer, has shown that substantial reductions of overtreatment and undertreatment results from molecular-based adjuvant therapy, and that this is cost-effective.
Since about 15% of patients have an indication for external beam radiotherapy, a new trial (PORTEC-5) is currently being designed to investigate hypofractionation, with separated schedules being compared for resilient and frail women.
&width=1536){kind=spacer}
Research on cervical cancer
The research on cervical cancer focuses on innovative effective treatments, and reduction of late effects and better quality of life. Participation in the EMBRACE collaboration and from early on strong participation in the EMBRACE-I and EMBRACE-II trials has led to improved outcomes. In collaboration with the Department of Gynaecology-Sexology (dr M.M. ter Kuile), a nurse-led program for sexual rehabilitation after such intensive treatment has been developed and the national multicentre SPARC trial has been initiated and recently published, showing the importance of extensive sexual rehabilitation after radiotherapy.
…The research on cervical cancer focuses on innovative effective treatments, and reduction of late effects and better quality of life. Participation in the EMBRACE collaboration and from early on strong participation in the EMBRACE-I and EMBRACE-II trials has led to improved outcomes. In collaboration with the Department of Gynaecology-Sexology (dr M.M. ter Kuile), a nurse-led program for sexual rehabilitation after such intensive treatment has been developed and the national multicentre SPARC trial has been initiated and recently published, showing the importance of extensive sexual rehabilitation after radiotherapy.
The PROTECT trial which is being conducted in collaboration with the ErasmusMC Dept of Radiation Oncology and Holland Proton Therapy Center, investigates the role of proton therapy compared to optimal VMAT photon therapy to reduced long-term toxicities, especially bone marrow function, immune function and bowel toxicity, in treatment of locally advanced cervical cancer. The photon phase of the study has been completed, and the expected start of the proton phase is in 2026.
Projects
Key publications
Results of the PORTEC-4 trial
Results of the PORTEC-3 trial
Results of the SPARC trial
Results of the AI based prognostic and predictive tools in endometrial cancer
Results of the PROTECT trial related studies
Team
- Professor Carien L. Creutzberg MD PhD, Radiation Oncologist, Chief investigator of the PORTEC trials, Link to University Leiden page: https://www.universiteitleiden.nl/en/staffmembers/carien-creutzberg#tab-1, Orcid https://orcid.org/0000-0002-7008-4321
- Nanda Horeweg MD PhD, Postdoc translational research, Orcid https://orcid.org/0000-0002-8581-4753
- Stephanie de Boer MD PHD, Radiation Oncologist, lead of the PROTECT trial, Orcid https://orcid.org/0000-0002-8454-1597
- Cathalijne Post, Anne-Sophie van den Heerik, Residents Radiation Oncology, PhD researchers
- Anne-Sophie van den Heerik, Orcid https://orcid.org/0000-0001-6403-0143
Resident in Radiation Oncology, PhD researcher - Anouk Corbeau, PhD researcher PROTECT
- Corine de Jong, MSc, research nurse specialist & SPARC trial
- Isabelle Suvaal MSc, PhD researcher SPARC trial
- Laura Velema MD, Radiation Oncologist, local EMBRACE lead
- Mila Donker MD PhD, Radiation Oncologist
- Affiliated: Prof dr Remi A. Nout, Radiation Oncologist, head ErasmusMC dept of Radiotherapy (until Sept 2019 senior researcher in our research group at LUMC)
