About our Department
The Department of Radiotherapy at the Erasmus MC Cancer Institute is committed to research for the betterment of clinical care. Completed research is often followed up by clinical implementation and novel strategies are tested in clinical trials. Since 2018, the department has moved to a new building with state-of-the-art radiotherapy equipment at Erasmus MC’s central campus in Rotterdam. The department is also strongly involved in the research and patient treatments in the Holland Proton Therapy Center in Delft.
Medical Physics and Technology
The Department of Radiotherapy at the Erasmus MC Cancer Institute has been at the forefront in developing automated treatment planning and high-precision adaptive radiotherapy approaches. This includes online and even real-time adaptive radiotherapy, robotic stereotactic body radiotherapy and proton therapy. Other focus areas are biology image-guided radiotherapy, and technology for interventional radiotherapy such as brachytherapy and hyperthermia. An important goal of the research program is to implement completed research and to evaluate the benefit.
Clinical research includes the development of clinical trials testing new treatment techniques for the reduction of radiation-induced side effects, and the creation of prospective cohort to capture the long-term radiation outcomes. Those cohorts will enable the development of predictive toxicity models and to test prevention strategies. They will also permit the discovery of mechanisms involved in toxicity or the prolonged survival after ablative treatment for oligometastatic patients.
Radiobiology ResearchThis covers research on the fundamental mechanism of the DNA damage response, specially damage induced by radiation. Understanding those mechanisms leads, beyond the mechanistic understanding, to the design of novel targeted approaches, including those modulating the DNA damage response such as hyperthermia or small molecule inhibitors, to increase the therapeutic windows between rapidly replicating cancer cells and normal tissues. It also leads to individualized radiation dose prescription if the tumor response to therapy of a given patient could be established based on radio- and thermo-biological molecular markers.
- Sebastiaan Breedveld, PhD
- Martine Franckena, PhD MD
- Dick van Gent, Prof PhD
- Jeremy Schiphof-Godart, PhD
- Wilma Heemsbergen, PhD
- Ben Heijmen, Prof PhD
- Steven Habraken, PhD
- Mischa Hoogeman, Prof PhD
- Luca Incrocci, Prof PhD MD
- Roland Kanaar, Prof PhD
- Inger-Karine Kolkman-Deurloo, PhD
- Alejandra Mendez Romero, PhD MD
- Julie Nonnekens, PhD
- Joost Nuyttens, PhD MD
- Steven Petit, PhD
Research at the Department of Radiotherapy at the Erasmus MC Cancer Institute is demarcated into three distinct domains/groups, these being:
- Medical Physics and Technology
- Molecular Biology
- Clinical research
Medical Physics and Technology
A significant component of the department of radiotherapy at the Erasmus MC Cancer Institute is actively involved the technological aspects of clinical care. Due in part because treatments involve sophisticated devices with evolving complexities, it is important that management of these devices is maintained with sufficiently trained persons (i.e. Clinical Physicists, Engineers) and ensure that the quality of treatment remains high for good clinical care.
Frequently, new developments become available that offer improvements to the standard of care, and since it is the departments desire to be at the forefront of the medical advancements, adequate resources are required to ensure a smooth transition from the development phase of new technologies to clinical rollout.
Radiobiology research is conducted alongside the Genetics Department and two professors are currently performing research on DNA repair mechanism inhibition using targeted therapies such as PARP inhibitors, Professor R. Kanaar and Professor C. Wyman.
Clinical research is initiated by research-driven scientists and supported by the clinical outcome unit, which is managed by René Vernhout and several staff.
The Clinical Outcome Unit enables the collection of prospective patient's data including well-defined pathology, various treatment modalities and highly specific endpoints (e.g. breast cardio-toxicity, prostate patients reported quality of life outcome).
Most important of all, the Clinical Outcome Unit facilities the running of clinical trials.
Jagt T, Breedveld S, van Haveren R, Heijmen B, Hoogeman M. An automated planning strategy for near real-time adaptive proton therapy in prostate cancer. Phys Med Biol. 2018 Jul 2;63(13):135017. doi: 10.1088/1361-6560/aacaa7. PubMed PMID: 29873296.
Incrocci L, Wortel RC, Alemayehu WG, Aluwini S, Schimmel E, Krol S, van der Toorn PP, Jager H, Heemsbergen W, Heijmen B, Pos F. Hypofractionated versus conventionally fractionated radiotherapy for patients with localised prostate cancer (HYPRO): final efficacy results from a randomised, multicentre, open-label, phase 3 trial. Lancet Oncol. 2016 Aug;17(8):1061-1069. doi: 10.1016/S1470-2045(16)30070-5. Epub 2016 Jun 20. PubMed PMID: 27339116.
The Effect of the Time Interval Between Radiation and Hyperthermia on Clinical Outcome in 400 Locally Advanced Cervical Carcinoma Patients.
Kroesen M, Mulder HT, van Holthe JML, Aangeenbrug AA, Mens JWM, van Doorn HC, Paulides MM, Oomen-de Hoop E, Vernhout RM, Lutgens LC, van Rhoon GC, Franckena M.
Front Oncol. 2019 Mar 8;9:134. doi: 10.3389/fonc.2019.00134. eCollection 2019.
Mild hyperthermia inhibits homologous recombination, induces BRCA2 degradation, and sensitizes cancer cells to poly (ADP-ribose) polymerase-1 inhibition. Krawczyk PM, Eppink B, Essers J, Stap J, Rodermond H, Odijk H, Zelensky A, van Bree C, Stalpers LJ, Buist MR, Soullié T, Rens J, Verhagen HJ, O'Connor MJ, Franken NA, Ten Hagen TL, Kanaar R, Aten JA. Proc Natl Acad Sci U S A. 2011 Jun 14;108(24):9851-6. Epub 2011 May 9.
The department of Radiotherapy within the Erasmus MC Cancer Institute in Rotterdam includes the satellite treatment center next to the Albert Schweitzer Hospital in Dordrecht.
Together with Dordrecht, the department manages ten Elekta Linacs (six Versa HD, four Agility), six surface guidance devices, two Cyberknifes (one with an in-room CT on rails), two brachy Afterloaders, three planning CT machines, and two hyperthermia devices (one for deep seated tumors like the cervix, and the other for targets within the head and neck region).
In addition, the department has shared resources with the radiology department including 1.5 and 3 T MRI scanners as well as PET scanner in the nuclear medicine department.
The department of Radiotherapy at Erasmus MC, together with the centers of TU delft and Leiden MC, equally founded HollandPTC - an independent outpatient center for proton therapy, scientific research and education, located in Delft.
Outside Erasmus MC Cancer Institute
- NVKF Nederlandse Vereniging voor Klinische Fysica
- NVKFM Nederlandse Vereniging Klinisch Fysisch Medewerkers
- NVRO Nederlandse Vereniging voor Radiotherapie en Oncologie
- ESTRO The European Society for Therapeutic Radiology and Oncology
- Holland PTC Proton Therapy Centre Delft
- SBE Erasmus MC Radiation Protection