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

The research within our LUMC departments is conducted within departmental research programmes. The research programme below is embedded within the department of Radiation Oncology.

Aim and focus

The department of Radiation Oncology is involved in clinical and translational 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, especially on rectal and endometrial cancer, 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. Topics within the area of long-term adverse effects are proton beam irradiation, reduction of late effects and rehabilitation for gynaecological tumours, organ sparing treatment in rectal cancers, and palliative medicine and radiotherapy. The department also supports TRFs from other departments for which LUMC is national or regional referral centre, such as cutaneous lymphomas, choroidal melanomas, and bone and soft tissue sarcomas. The proton beam facility has the only eye treatment beam in the Netherlands and the department will be the national centre for both brachytherapy and proton therapy of eye melanomas.

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 four PORTEC-trials on endometrial carcinoma, and the three trials of the  Dutch Bone Metastasis Study Group. The department has played a coordinating role in several other large national randomized trials. All PIs have leading roles in national and international organisations and networks, (NVRO Concilium, NVRO Scientific Committee, Dutch Cancer Society, DCCG, DGOG) and international oncology organisations (ESTRO board, ESTRO teachers, ESTRO Scientific Advisory Groups, IGCS Council, ESGO Council and Scientific Committee, GCIG) ), The investigators have received major grants for further research, not only in clinical trials but also translational research and rehabilitation projects. There is a leading role in the national and international programs on palliative care. In addition, the department is very active in late outcome registration. Lastly, there is aa strong collaboration with Erasmus University Oncology Centre and Delft University in the development of a proton irradiation facility for treatment and research, which is symbolised by the Medical Delta Professorship of Corrie Marijnen.

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 and many side studies on decision making, translational research and radiation therapy improvement have been done. 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. Late outcome, cancer survivorship and quality of life, and translational research studies have evolved from these trials. The ongoing 4th PORTEC trial is the first in the field of integrated clinical and molecular risk profiling determining the indication for adjuvant treatment. The bone metastasis trial has made ‘1x8 Gy’ the treatment of choice. All of these trials have led to many side studies, translational work, major international presentations and publications and theses.

Future themes

  • Translational research studies: rectal and endometrial cancer 
  • Decision making and communication studies: rectal cancer and endometrial cancer
  • Survivorship and quality of life studies: rectal and endometrial cancer; proton irradiation; Hodgkin lymphoma 
  • Organ preservation studies: rectal cancer; choroidal melanoma; development of proton treatment of ocular melanomas. 
  • New treatment approaches: brachytherapy, proton irradiation 
  • Biomedical imaging: MR-guided radiotherapy
  • Palliative medicine and palliative radiotherapy studies

Cohesion within LUMC

The research is conducted in strong collaboration with the departments of, Pathology, Radiology, Surgical Oncology, Biostatistics, Medical Decision making, Gynaecologic Oncology, Radiology, Ophtalmology, and Medical Oncology.