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1. Efficacy of a nurse-led sexual rehabilitation intervention for women with gynaecological cancers receiving radiotherapy: results of a randomised trial

Author

Suvaal, Isabelle, Hummel, Susanna B., Mens, Jan-Willem M., Tuijnman-Raasveld, Charlotte C., Tsonaka, Roula, Velema, Laura A., Westerveld, Henrike, Cnossen, Jeltsje S., Snyers, An, Jürgenliemk-Schulz, Ina M., Lutgens, Ludy C. H. W., Beukema, Jannet C., Haverkort, Marie A. D., Nowee, Marlies E., Nout, Remi A., de Kroon, Cor D., van den Hout, Wilbert B., Creutzberg, Carien L., van Doorn, Helena C., and ter Kuile, Moniek M.

Published
2024
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2. Prognostic refinement of NSMP high-risk endometrial cancers using oestrogen receptor immunohistochemistry

Author

Vermij, Lisa, Jobsen, Jan J., León-Castillo, Alicia, Brinkhuis, Mariel, Roothaan, Suzan, Powell, Melanie E., de Boer, Stephanie M., Khaw, Pearly, Mileshkin, Linda R., Fyles, Anthony, Leary, Alexandra, Genestie, Catherine, Jürgenliemk-Schulz, Ina M., Crosbie, Emma J., Mackay, Helen J., Nijman, Hans. W., Nout, Remi A., Smit, Vincent T. H. B. M., Creutzberg, Carien L., Horeweg, Nanda, and Bosse, Tjalling

Published
2023
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3. Dose evaluation of fast synthetic-CT generation using a generative adversarial network for general pelvis MR-only radiotherapy

Author

Maspero, Matteo, Savenije, Mark H. F., Dinkla, Anna M., Seevinck, Peter R., Intven, Martijn P. W., Jurgenliemk-Schulz, Ina M., Kerkmeijer, Linda G. W., and Berg, Cornelis A. T. van den

Subjects
Physics - Medical Physics
Abstract

To enable magnetic resonance (MR)-only radiotherapy and facilitate modelling of radiation attenuation in humans, synthetic-CT (sCT) images need to be generated. Considering the application of MR-guided radiotherapy and online adaptive replanning, sCT generation should occur within minutes. This work aims at assessing whether an existing deep learning network can rapidly generate sCT images to be used for accurate MR-based dose calculations in the entire pelvis. A study was conducted on data of 91 patients with prostate, rectal and cervical cancer who underwent external beam radiotherapy acquiring both CT and MRI for patients' simulation. Dixon reconstructed water, fat and in-phase images obtained from a conventional dual gradient-recalled echo sequence were used to generate sCT images. A conditional generative adversarial network (cGAN) was trained in a paired fashion on 2D transverse slices of 32 prostate cancer patients. The trained network was tested on the remaining patients to generate sCT images. For 30 patients in the test set, dose recalculations of the clinical plan were performed on sCT images. Dose distributions were evaluated comparing voxel-based dose differences, gamma and dose-volume histogram (DVH) analysis. The sCT generation required 5.6 s and 21 s for a single patient volume on a GPU and CPU, respectively. On average, sCT images resulted in a higher dose to the target of maximum 0.3%. Results suggest that accurate MR-based dose calculation using sCT images generated with a cGAN trained on prostate cancer patients is feasible for the entire pelvis. The sCT generation was sufficiently fast to be integrated into an MR-guided radiotherapy workflow., Comment: Accepted for publication in Physics in Medicine and Biology, in press (2018)

Published
2018
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4. Tertiary lymphoid structures critical for prognosis in endometrial cancer patients

Author

Horeweg, Nanda, Workel, Hagma H., Loiero, Dominik, Church, David N., Vermij, Lisa, Léon-Castillo, Alicia, Krog, Ricki T., de Boer, Stephanie M., Nout, Remi A., Powell, Melanie E., Mileshkin, Linda R., MacKay, Helen, Leary, Alexandra, Singh, Naveena, Jürgenliemk-Schulz, Ina M., Smit, Vincent T. H. B. M., Creutzberg, Carien L., Koelzer, Viktor H., Nijman, Hans W., Bosse, Tjalling, and de Bruyn, Marco

Published
2022
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5. Symptomatic lymphocele after robot-assisted pelvic lymphadenectomy as part of the primary surgical treatment for cervical and endometrial cancer: a retrospective cohort study

Author

MS Gynaecologische Oncologie, Cancer, MS Radiotherapie, de Jong, Alise, Baeten, Ilse G T, Jansen, Anna, Hoogendam, Jacob P, Jürgenliemk-Schulz, Ina M, Zweemer, Ronald P, Gerestein, Cornelis G, MS Gynaecologische Oncologie, Cancer, MS Radiotherapie, de Jong, Alise, Baeten, Ilse G T, Jansen, Anna, Hoogendam, Jacob P, Jürgenliemk-Schulz, Ina M, Zweemer, Ronald P, and Gerestein, Cornelis G

Published
2024

6. Abstract 5695: Deep learning risk prediction model of distant recurrence from H&E endometrial cancer slides

Author

Fremond, Sarah, primary, Andani, Sonali, additional, Wolf, Jurriaan Barkey, additional, Ørtoft, Gitte, additional, Høgdall, Estrid, additional, Dijkstra, Jouke, additional, Jobsen, Jan J., additional, Jürgenliemk-Schulz, Ina M., additional, Lutgens, Ludy CHW, additional, Powell, Melanie E., additional, Singh, Naveena, additional, Mileshkin, Linda R., additional, Mackay, Helen J., additional, Leary, Alexandra, additional, Katsaros, Dionyssios, additional, Nijman, Hans W., additional, de Boer, Stephanie M., additional, Nout, Remi A., additional, Smit, Vincent T.H.B.M, additional, Creutzberg, Carien L., additional, Horeweg, Nanda, additional, Koelzer, Viktor H., additional, and Bosse, Tjalling, additional

Published
2023
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7. Multi-center dosimetric predictions to improve plan quality for brachytherapy for cervical cancer treatment

Author

Reijtenbagh, Dominique M.W., Godart, Jérémy, de Leeuw, Astrid A.C., Jürgenliemk-Schulz, Ina M., Mens, Jan Willem M., Huge, Michèle, Hoogeman, Mischa S., Reijtenbagh, Dominique M.W., Godart, Jérémy, de Leeuw, Astrid A.C., Jürgenliemk-Schulz, Ina M., Mens, Jan Willem M., Huge, Michèle, and Hoogeman, Mischa S.

Abstract

Background and purpose: Image-guided adaptive brachytherapy (IGABT) is an important modality in the cervical cancer treatment, and plan quality is sensitive to time pressure in the workflow. Patient anatomy-based quality-assurance (QA) with overlap volume histograms (OVHs) has been demonstrated to detect suboptimal plans (outliers). This analysis quantifies the possible improvement of plans detected as outliers, and investigates its suitability as a clinical QA tool in a multi-center setting. Materials and methods: In previous work OVH-based models were investigated for the use of QA. In this work a total of 160 plans of 68 patients treated in accordance with the current state-of-the-art IGABT protocol from Erasmus MC (EMC) were analyzed, with a model based on 120 plans (60 patients) from UMC Utrecht (UMCU). Machine-learning models were trained to define QA thresholds, and to predict dose D2cm3 to bladder, rectum, sigmoid and small bowel with the help of OVHs of the EMC cohort. Plans out of set thresholds (outliers) were investigated and retrospectively replanned based on predicted D2cm3 values. Results: Analysis of replanned plans demonstrated a median improvement of 0.62 Gy for all Organs At Risk (OARs) combined and an improvement for 96 % of all replanned plans. Outlier status was resolved for 36 % of the replanned plans. The majority of the plans that could not be replanned were reported having implantation complications or insufficient coverage due to tumor geometry. Conclusion: OVH-based QA models can detect suboptimal plans, including both unproblematic BT applications and suboptimal planning circumstances in general. OVH-based QA models demonstrate potential for clinical use in terms of performance and user-friendliness, and could be used for knowledge transfer between institutes. Further research is necessary to differentiate between (sub)optimal planning circumstances.

Published
2023

8. In Reply to Murakami et al

Author

MS Radiotherapie, Cancer, Vittrup, Anders Schwartz, Spampinato, Sofia, Jensen, Nina Boje Kibsgaard, Tanderup, Kari, Kirchheiner, Kathrin, Pötter, Richard, Nout, Remi, Jürgenliemk-Schulz, Ina M, MS Radiotherapie, Cancer, Vittrup, Anders Schwartz, Spampinato, Sofia, Jensen, Nina Boje Kibsgaard, Tanderup, Kari, Kirchheiner, Kathrin, Pötter, Richard, Nout, Remi, and Jürgenliemk-Schulz, Ina M

Published
2023

10. Multi-center dosimetric predictions to improve plan quality for brachytherapy for cervical cancer treatment

Author

Klinische Fysica RT, Cancer, MS Radiotherapie, Reijtenbagh, Dominique M W, Godart, Jérémy, de Leeuw, Astrid A C, Jürgenliemk-Schulz, Ina M, Mens, Jan-Willem M, Huge, Michèle, Hoogeman, Mischa S, Klinische Fysica RT, Cancer, MS Radiotherapie, Reijtenbagh, Dominique M W, Godart, Jérémy, de Leeuw, Astrid A C, Jürgenliemk-Schulz, Ina M, Mens, Jan-Willem M, Huge, Michèle, and Hoogeman, Mischa S

Published
2023

11. Introducing a novice surgeon to an experienced robotic gynaecological oncology team: An observational cohort study on the impact of a structured curriculum on outcomes of cervical cancer surgery

Author

MS Gynaecologische Oncologie, Cancer, MS Radiotherapie, Baeten, Ilse G.T., Hoogendam, Jacob P., Schreuder, Henk W.R., Jürgenliemk-Schulz, Ina M., Gerestein, Cornelis G., Zweemer, Ronald P., MS Gynaecologische Oncologie, Cancer, MS Radiotherapie, Baeten, Ilse G.T., Hoogendam, Jacob P., Schreuder, Henk W.R., Jürgenliemk-Schulz, Ina M., Gerestein, Cornelis G., and Zweemer, Ronald P.

Published
2023

12. Online adaptive MR-guided radiotherapy: Conformity of contour adaptation for prostate cancer, rectal cancer and lymph node oligometastases among radiation therapists and radiation oncologists

Author

Rasing, Marnix J.A., primary, Sikkes, Gonda G., additional, Vissers, Nicole G.P.M., additional, Kotte, Alexis N.T.J., additional, Boudewijn, Joske H., additional, Doornaert, Patricia A.H., additional, Eppinga, Wietse S.C., additional, Intven, Martijn, additional, Rutgers, Reijer H.A., additional, Scheeren, Annick, additional, Snoeren, Louk M.W., additional, Vlig, Tiny B., additional, van der Voort van Zyp, Jochem R.N., additional, Wijkhuizen, Lisa M., additional, van Rossum, Peter S.N., additional, Peters, Max, additional, and Jürgenliemk-Schulz, Ina M., additional

Published
2022
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13. Fluorescent Indocyanine Green versus Technetium-99m and Blue Dye for Bilateral SENTinel Lymph Node Detection in Stage I–IIA Cervical Cancer (FluoreSENT): protocol for a non-inferiority study

Author

Baeten, Ilse G T, primary, Hoogendam, Jacob P, additional, Braat, Arthur J A T, additional, Veldhuis, Wouter B, additional, Jonges, Geertruida N, additional, Jürgenliemk-Schulz, Ina M, additional, Zweemer, Ronald P, additional, and Gerestein, Cornelis G, additional

Published
2022
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14. Impact of magnetic resonance-guided versus conventional radiotherapy workflows on organ at risk doses in stereotactic body radiotherapy for lymph node oligometastases

Author

Werensteijn-Honingh, Anita M., primary, Kroon, Petra S., additional, Winkel, Dennis, additional, van Gaal, J. Carlijn, additional, Hes, Jochem, additional, Snoeren, Louk M.W., additional, Timmer, Jaleesa K., additional, Mout, Christiaan C.P., additional, Bol, Gijsbert H., additional, Kotte, Alexis N., additional, Eppinga, Wietse S.C., additional, Intven, Martijn, additional, Raaymakers, Bas W., additional, and Jürgenliemk-Schulz, Ina M., additional

Published
2022
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16. First multicentre experience of SABR for lymph node and liver oligometastatic disease on the unity MR-Linac

Author

Janssen, Tomas M., primary, Aitken, Katharine, additional, Alongi, Filippo, additional, Barry, Aisling, additional, Bernchou, Uffe, additional, Boeke, Simon, additional, Hall, William A., additional, Hosni, Ali, additional, Kroon, Petra.S., additional, Nachbar, Marcel, additional, Saeed, Hina, additional, Jürgenliemk-Schulz, Ina M., additional, Schytte, Tine, additional, Verkooijen, Helena M., additional, and Nowee, Marlies.E., additional

Published
2022
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17. Role of Brachytherapy in the Postoperative Management of Endometrial Cancer: Decision-Making Analysis among Experienced European Radiation Oncologists

Author

Glatzer, Markus, Tanderup, Kari, Rovirosa, Angeles, Fokdal, Lars, Ordeanu, Claudia, Tagliaferri, Luca, Chargari, Cyrus, Strnad, Vratislav, Dimopoulos, Johannes Athanasios, Šegedin, Barbara, Cooper, Rachel, Nakken, Esten Søndrol, Petric, Primoz, van der Steen-Banasik, Elzbieta, Lössl, Kristina, Jürgenliemk-Schulz, Ina M, Niehoff, Peter, Hermansson, Ruth S, Nout, Remi A, Putora, Paul Martin, Plasswilm, Ludwig, Tselis, Nikolaos, Radiotherapy, University of Zurich, and Glatzer, Markus

Subjects
Cancer Research, Brachytherapy, 610 Medicine & health, 10044 Clinic for Radiation Oncology, Endometrial cancer, Oncology, SDG 3 - Good Health and Well-being, Decision tree, 2730 Oncology, 1306 Cancer Research, ddc:610, decision-making, endometrial cancer, brachytherapy, decision tree, Decision-making
Abstract

Simple Summary There are various society-specific guidelines addressing adjuvant brachytherapy (BT) after surgery for endometrial cancer (EC). However, these recommendations are not uniform. Against this background, clinicians need to make decisions despite gaps between best scientific evidence and clinical practice. We analysed decision criteria influencing the selection for adjuvant radiotherapy among European radiation oncology experts. For this, GEC-ESTRO provided 19 European radiation oncology experts on gynaecological brachytherapy for decision-making analyses. The manuscript presents patterns in decision-making among these experts and demonstrates areas of consensus/discrepancies. We also analysed dose prescription and techniques of brachytherapy. This analysis is of special value as the objective approach enabled us to obtain an unbiased description of decision-making among the specialists (the study was not aimed to create or enforce a consensus). The manuscript provides valuable insight into clinical decision-making with a high impact on treatment selection, as expected differences between experts were observed. With this manuscript we are able to visualize and quantify these. This information is relevant for interdisciplinary discussions. Abstract Background: There are various society-specific guidelines addressing adjuvant brachytherapy (BT) after surgery for endometrial cancer (EC). However, these recommendations are not uniform. Against this background, clinicians need to make decisions despite gaps between best scientific evidence and clinical practice. We explored factors influencing decision-making for adjuvant BT in clinical routine among experienced European radiation oncologists in the field of gynaecological radiotherapy (RT). We also investigated the dose and technique of BT. Methods: Nineteen European experts for gynaecological BT selected by the Groupe Européen de Curiethérapie and the European Society for Radiotherapy & Oncology provided their decision criteria and technique for postoperative RT in EC. The decision criteria were captured and converted into decision trees, and consensus and dissent were evaluated based on the objective consensus methodology. Results: The decision criteria used by the experts were tumour extension, grading, nodal status, lymphovascular invasion, and cervical stroma/vaginal invasion (yes/no). No expert recommended adjuvant BT for pT1a G1-2 EC without substantial LVSI. Eighty-four percent of experts recommended BT for pT1a G3 EC without substantial LVSI. Up to 74% of experts used adjuvant BT for pT1b LVSI-negative and pT2 G1–2 LVSI-negative disease. For 74–84% of experts, EBRT + BT was the treatment of choice for nodal-positive pT2 disease and for pT3 EC with cervical/vaginal invasion. For all other tumour stages, there was no clear consensus for adjuvant treatment. Four experts already used molecular markers for decision-making. Sixty-five percent of experts recommended fractionation regimens of 3 × 7 Gy or 4 × 5 Gy for BT as monotherapy and 2 × 5 Gy for combination with EBRT. The most commonly used applicator for BT was a vaginal cylinder; 82% recommended image-guided BT. Conclusions: There was a clear trend towards adjuvant BT for stage IA G3, stage IB, and stage II G1–2 LVSI-negative EC. Likewise, there was a non-uniform pattern for BT dose prescription but a clear trend towards 3D image-based BT. Finally, molecular characteristics were already used in daily decision-making by some experts under the pretext that upcoming trials will bring more clarity to this topic.

Published
2022
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18. Role of Brachytherapy in the Postoperative Management of Endometrial Cancer:Decision-Making Analysis among Experienced European Radiation Oncologists

Author

Glatzer, Markus, Tanderup, Kari, Rovirosa, Angeles, Fokdal, Lars, Ordeanu, Claudia, Tagliaferri, Luca, Chargari, Cyrus, Strnad, Vratislav, Dimopoulos, Johannes Athanasios, Šegedin, Barbara, Cooper, Rachel, Nakken, Esten Søndrol, Petric, Primoz, van der Steen-Banasik, Elzbieta, Lössl, Kristina, Jürgenliemk-Schulz, Ina M., Niehoff, Peter, Hermansson, Ruth S., Nout, Remi A., Putora, Paul Martin, Plasswilm, Ludwig, Tselis, Nikolaos, Glatzer, Markus, Tanderup, Kari, Rovirosa, Angeles, Fokdal, Lars, Ordeanu, Claudia, Tagliaferri, Luca, Chargari, Cyrus, Strnad, Vratislav, Dimopoulos, Johannes Athanasios, Šegedin, Barbara, Cooper, Rachel, Nakken, Esten Søndrol, Petric, Primoz, van der Steen-Banasik, Elzbieta, Lössl, Kristina, Jürgenliemk-Schulz, Ina M., Niehoff, Peter, Hermansson, Ruth S., Nout, Remi A., Putora, Paul Martin, Plasswilm, Ludwig, and Tselis, Nikolaos

Abstract

Background: There are various society-specific guidelines addressing adjuvant brachytherapy (BT) after surgery for endometrial cancer (EC). However, these recommendations are not uniform. Against this background, clinicians need to make decisions despite gaps between best scientific evidence and clinical practice. We explored factors influencing decision-making for adjuvant BT in clinical routine among experienced European radiation oncologists in the field of gynaecological radiotherapy (RT). We also investigated the dose and technique of BT. Methods: Nineteen European experts for gynaecological BT selected by the Groupe Européen de Curiethérapie and the European Society for Radiotherapy & Oncology provided their decision criteria and technique for postoperative RT in EC. The decision criteria were captured and converted into decision trees, and consensus and dissent were evaluated based on the objective consensus methodology. Results: The decision criteria used by the experts were tumour extension, grading, nodal status, lymphovascular invasion, and cervical stroma/vaginal invasion (yes/no). No expert recommended adjuvant BT for pT1a G1-2 EC without substantial LVSI. Eighty-four percent of experts recommended BT for pT1a G3 EC without substantial LVSI. Up to 74% of experts used adjuvant BT for pT1b LVSI-negative and pT2 G1–2 LVSI-negative disease. For 74–84% of experts, EBRT + BT was the treatment of choice for nodal-positive pT2 disease and for pT3 EC with cervical/vaginal invasion. For all other tumour stages, there was no clear consensus for adjuvant treatment. Four experts already used molecular markers for decision-making. Sixty-five percent of experts recommended fractionation regimens of 3 × 7 Gy or 4 × 5 Gy for BT as monotherapy and 2 × 5 Gy for combination with EBRT. The most commonly used applicator for BT was a vaginal cylinder; 82% recommended image-guided BT. Conclusion: There was a clear trend towards adjuvant BT for stage IA G3, stage IB, and

Published
2022

19. Automated causal inference in application to randomized controlled clinical trials

Author

Wu, Ji Q., Horeweg, Nanda, de Bruyn, Marco, Nout, Remi A., Jürgenliemk-Schulz, Ina M., Lutgens, Ludy C.H.W., Jobsen, Jan J., van der Steen-Banasik, Elzbieta M., Nijman, Hans W., Smit, Vincent T.H.B.M., Bosse, Tjalling, Creutzberg, Carien L., Koelzer, Viktor H., Wu, Ji Q., Horeweg, Nanda, de Bruyn, Marco, Nout, Remi A., Jürgenliemk-Schulz, Ina M., Lutgens, Ludy C.H.W., Jobsen, Jan J., van der Steen-Banasik, Elzbieta M., Nijman, Hans W., Smit, Vincent T.H.B.M., Bosse, Tjalling, Creutzberg, Carien L., and Koelzer, Viktor H.

Abstract

Randomized controlled trials (RCTs) are considered the gold standard for testing causal hypotheses in the clinical domain; however, the investigation of prognostic variables of patient outcome in a hypothesized cause–effect route is not feasible using standard statistical methods. Here we propose a new automated causal inference method (AutoCI) built on the invariant causal prediction (ICP) framework for the causal reinterpretation of clinical trial data. Compared with existing methods, we show that the proposed AutoCI allows one to clearly determine the causal variables of two real-world RCTs of patients with endometrial cancer with mature outcome and extensive clinicopathological and molecular data. This is achieved via suppressing the causal probability of non-causal variables by a wide margin. In ablation studies, we further demonstrate that the assignment of causal probabilities by AutoCI remains consistent in the presence of confounders. In conclusion, these results confirm the robustness and feasibility of AutoCI for future applications in real-world clinical analysis.

Published
2022

20. Multi-modal volumetric concept activation to explain detection and classification of metastatic prostate cancer on PSMA-PET/CT

Author

Kraaijveld, Rosa C. J., Philippens, Marielle E. P., Eppinga, Wietse S. C., Jürgenliemk-Schulz, Ina M., Gilhuijs, Kenneth G. A., Kroon, Petra S., van der Velden, Bas H. M., Kraaijveld, Rosa C. J., Philippens, Marielle E. P., Eppinga, Wietse S. C., Jürgenliemk-Schulz, Ina M., Gilhuijs, Kenneth G. A., Kroon, Petra S., and van der Velden, Bas H. M.

Abstract

Explainable artificial intelligence (XAI) is increasingly used to analyze the behavior of neural networks. Concept activation uses human-interpretable concepts to explain neural network behavior. This study aimed at assessing the feasibility of regression concept activation to explain detection and classification of multi-modal volumetric data. Proof-of-concept was demonstrated in metastatic prostate cancer patients imaged with positron emission tomography/computed tomography (PET/CT). Multi-modal volumetric concept activation was used to provide global and local explanations. Sensitivity was 80% at 1.78 false positive per patient. Global explanations showed that detection focused on CT for anatomical location and on PET for its confidence in the detection. Local explanations showed promise to aid in distinguishing true positives from false positives. Hence, this study demonstrated feasibility to explain detection and classification of multi-modal volumetric data using regression concept activation., Comment: Accepted as: Kraaijveld, R.C.J., Philippens, M.E.P., Eppinga, W.S.C., J\"urgenliemk-Schulz, I.M., Gilhuijs, K.G.A., Kroon, P.S., van der Velden, B.H.M. "Multi-modal volumetric concept activation to explain detection and classification of metastatic prostate cancer on PSMA-PET/CT." MICCAI workshop on Interpretability of Machine Intelligence in Medical Image Computing (iMIMIC), 2022

Published
2022

21. Defining Substantial Lymphovascular Space Invasion in Endometrial Cancer

Author

Peters, Elke E.M., León-Castillo, Alicia, Smit, Vincent T.H.B.M., Boennelycke, Marie, Hogdall, Estrid, Hogdall, Claus, Creutzberg, Carien, Jürgenliemk-Schulz, Ina M., Jobsen, Jan J., Mens, Jan Willem M., Lutgens, Ludy C.H.W., Van Der Steen-Banasik, Elzbieta M., Ortoft, Gitte, Bosse, Tjalling, Nout, Remi, Peters, Elke E.M., León-Castillo, Alicia, Smit, Vincent T.H.B.M., Boennelycke, Marie, Hogdall, Estrid, Hogdall, Claus, Creutzberg, Carien, Jürgenliemk-Schulz, Ina M., Jobsen, Jan J., Mens, Jan Willem M., Lutgens, Ludy C.H.W., Van Der Steen-Banasik, Elzbieta M., Ortoft, Gitte, Bosse, Tjalling, and Nout, Remi

Abstract

Lymphovascular space invasion (LVSI) occurs in a minority of endometrial cancer (EC) cases, and the extent of LVSI is an important risk factor for recurrence and/or metastases. Our aim was to improve the reproducibility of measuring clinically meaningful LVSI by performing a quantitative analysis of the correlation between LVSI and the risk of pelvic lymph node recurrence in EC. EC samples from PORTEC-1 and PORTEC-2 trials were retrieved and used to collect quantitative data, including the number of LVSI-positive vessels per H&E-stained slide. Using a predefined threshold for clinical relevance, the risk of pelvic lymph node recurrence risk was calculated (Kaplan-Meier method, with Cox regression) using a stepwise adjustment for the number of LVSI-positive vessels. This analysis was then repeated in the Danish Gynecological Cancer Database (DGCD) cohort. Among patients in PORTEC-1 and PORTEC-2 trials who did not receive external beam radiotherapy, the 5-yr pelvic lymph node recurrence risk was 3.3%, 6.7% (P=0.51), and 26.3% (P<0.001), respectively when 0, 1 to 3, or ≥4 vessels had LVSI involvement; similar results were obtained for the DGCD cohort. Furthermore, both the average number of tumor cells in the largest embolus and the number of LVSI-positive H&E slides differed significantly between focal LVSI and substantial LVSI. On the basis of these results, we propose a numeric threshold (≥4 LVSI-involved vessels in at least one H&E slide) for defining clinically relevant LVSI in EC, thereby adding supportive data to the semiquantitative approach. This will help guide gynecologic pathologists to differentiate between focal and substantial LVSI, especially in borderline cases.

Published
2022

22. Automated causal inference in application to randomized controlled clinical trials

Author

Wu, Jiqing, Horeweg, Nanda, de Bruyn, Marco, Nout, Remi A., Jürgenliemk-Schulz, Ina M., Lutgens, Ludy C. H. W., Jobsen, Jan J., van der Steen-Banasik, Elzbieta M., Nijman, Hans W., Smit, Vincent T. H. B. M., Bosse, Tjalling, Creutzberg, Carien L., Koelzer, Viktor H., Wu, Jiqing, Horeweg, Nanda, de Bruyn, Marco, Nout, Remi A., Jürgenliemk-Schulz, Ina M., Lutgens, Ludy C. H. W., Jobsen, Jan J., van der Steen-Banasik, Elzbieta M., Nijman, Hans W., Smit, Vincent T. H. B. M., Bosse, Tjalling, Creutzberg, Carien L., and Koelzer, Viktor H.

Abstract

Randomized controlled trials (RCTs) are considered as the gold standard for testing causal hypotheses in the clinical domain. However, the investigation of prognostic variables of patient outcome in a hypothesized cause-effect route is not feasible using standard statistical methods. Here, we propose a new automated causal inference method (AutoCI) built upon the invariant causal prediction (ICP) framework for the causal re-interpretation of clinical trial data. Compared to existing methods, we show that the proposed AutoCI allows to efficiently determine the causal variables with a clear differentiation on two real-world RCTs of endometrial cancer patients with mature outcome and extensive clinicopathological and molecular data. This is achieved via suppressing the causal probability of non-causal variables by a wide margin. In ablation studies, we further demonstrate that the assignment of causal probabilities by AutoCI remain consistent in the presence of confounders. In conclusion, these results confirm the robustness and feasibility of AutoCI for future applications in real-world clinical analysis., Comment: Submitted to Nature Machine Intelligence. The code is publicly available via https://github.com/CTPLab/AutoCI

Published
2022

23. Defining Substantial Lymphovascular Space Invasion in Endometrial Cancer

Author

MS Radiotherapie, Cancer, Peters, Elke E.M., León-Castillo, Alicia, Smit, Vincent T.H.B.M., Boennelycke, Marie, Hogdall, Estrid, Hogdall, Claus, Creutzberg, Carien, Jürgenliemk-Schulz, Ina M., Jobsen, Jan J., Mens, Jan Willem M., Lutgens, Ludy C.H.W., Van Der Steen-Banasik, Elzbieta M., Ortoft, Gitte, Bosse, Tjalling, Nout, Remi, MS Radiotherapie, Cancer, Peters, Elke E.M., León-Castillo, Alicia, Smit, Vincent T.H.B.M., Boennelycke, Marie, Hogdall, Estrid, Hogdall, Claus, Creutzberg, Carien, Jürgenliemk-Schulz, Ina M., Jobsen, Jan J., Mens, Jan Willem M., Lutgens, Ludy C.H.W., Van Der Steen-Banasik, Elzbieta M., Ortoft, Gitte, Bosse, Tjalling, and Nout, Remi

Published
2022

24. Radiation Therapy Techniques and Treatment-Related Toxicity in the PORTEC-3 Trial: Comparison of 3-Dimensional Conformal Radiation Therapy Versus Intensity-Modulated Radiation Therapy

Author

MS Radiotherapie, Cancer, Wortman, Bastiaan G., Post, Cathalijne C.B., Powell, Melanie E., Khaw, Pearly, Fyles, Anthony, D'Amico, Romerai, Haie-Meder, Christine, Jürgenliemk-Schulz, Ina M., McCormack, Mary, Do, Viet, Katsaros, Dionyssios, Bessette, Paul, Baron, Marie Hélène, Nout, Remi A., Whitmarsh, Karen, Mileshkin, Linda, Lutgens, Ludy C.H.W., Kitchener, Henry C., Brooks, Susan, Nijman, Hans W., Astreinidou, Eleftheria, Putter, Hein, Creutzberg, Carien L., de Boer, Stephanie M., MS Radiotherapie, Cancer, Wortman, Bastiaan G., Post, Cathalijne C.B., Powell, Melanie E., Khaw, Pearly, Fyles, Anthony, D'Amico, Romerai, Haie-Meder, Christine, Jürgenliemk-Schulz, Ina M., McCormack, Mary, Do, Viet, Katsaros, Dionyssios, Bessette, Paul, Baron, Marie Hélène, Nout, Remi A., Whitmarsh, Karen, Mileshkin, Linda, Lutgens, Ludy C.H.W., Kitchener, Henry C., Brooks, Susan, Nijman, Hans W., Astreinidou, Eleftheria, Putter, Hein, Creutzberg, Carien L., and de Boer, Stephanie M.

Published
2022

25. Dose-effect relationship between vaginal dose points and vaginal stenosis in cervical cancer: An EMBRACE-I sub-study

Author

MS Radiotherapie, Cancer, Klinische Fysica RT, Westerveld, Henrike, Kirchheiner, Kathrin, Nout, Remi A., Tanderup, Kari, Lindegaard, Jacob C., Spampinato, Sofia, Sturdza, Alina, Nesvacil, Nicole, Bruheim, Kjersti, Hellebust, Taran P., Pieters, Bradley R., Kirisits, Christian, Jürgenliemk-Schulz, Ina M., Pötter, Richard, de Leeuw, Astrid A.C., MS Radiotherapie, Cancer, Klinische Fysica RT, Westerveld, Henrike, Kirchheiner, Kathrin, Nout, Remi A., Tanderup, Kari, Lindegaard, Jacob C., Spampinato, Sofia, Sturdza, Alina, Nesvacil, Nicole, Bruheim, Kjersti, Hellebust, Taran P., Pieters, Bradley R., Kirisits, Christian, Jürgenliemk-Schulz, Ina M., Pötter, Richard, and de Leeuw, Astrid A.C.

Published
2022

26. Role of Brachytherapy in the Postoperative Management of Endometrial Cancer: Decision-Making Analysis among Experienced European Radiation Oncologists

Author

MS Radiotherapie, Cancer, Glatzer, Markus, Tanderup, Kari, Rovirosa, Angeles, Fokdal, Lars, Ordeanu, Claudia, Tagliaferri, Luca, Chargari, Cyrus, Strnad, Vratislav, Dimopoulos, Johannes Athanasios, Šegedin, Barbara, Cooper, Rachel, Nakken, Esten Søndrol, Petric, Primoz, van der Steen-Banasik, Elzbieta, Lössl, Kristina, Jürgenliemk-Schulz, Ina M., Niehoff, Peter, Hermansson, Ruth S., Nout, Remi A., Putora, Paul Martin, Plasswilm, Ludwig, Tselis, Nikolaos, MS Radiotherapie, Cancer, Glatzer, Markus, Tanderup, Kari, Rovirosa, Angeles, Fokdal, Lars, Ordeanu, Claudia, Tagliaferri, Luca, Chargari, Cyrus, Strnad, Vratislav, Dimopoulos, Johannes Athanasios, Šegedin, Barbara, Cooper, Rachel, Nakken, Esten Søndrol, Petric, Primoz, van der Steen-Banasik, Elzbieta, Lössl, Kristina, Jürgenliemk-Schulz, Ina M., Niehoff, Peter, Hermansson, Ruth S., Nout, Remi A., Putora, Paul Martin, Plasswilm, Ludwig, and Tselis, Nikolaos

Published
2022

27. Risk Factors for Late Persistent Fatigue After Chemoradiotherapy in Patients With Locally Advanced Cervical Cancer: An Analysis From the EMBRACE-I Study

Author

MS Radiotherapie, Cancer, Smet, Stéphanie, Spampinato, Sofia, Pötter, Richard, Jürgenliemk-Schulz, Ina M., Nout, Remi A., Chargari, Cyrus, Mahantshetty, Umesh, Sturdza, Alina, Segedin, Barbara, Bruheim, Kjersti, Hoskin, Peter, Rai, Bhavana, Huang, Fleur, Cooper, Rachel, Van der Steen-Banasik, Elzbieta, Sundset, Marit, Van Limbergen, Erik, Tan, Li Tee, Lutgens, Ludy C.H.W., Villafranca, Elena, Pieters, Bradley R., Tanderup, Kari, Kirchheiner, Kathrin, MS Radiotherapie, Cancer, Smet, Stéphanie, Spampinato, Sofia, Pötter, Richard, Jürgenliemk-Schulz, Ina M., Nout, Remi A., Chargari, Cyrus, Mahantshetty, Umesh, Sturdza, Alina, Segedin, Barbara, Bruheim, Kjersti, Hoskin, Peter, Rai, Bhavana, Huang, Fleur, Cooper, Rachel, Van der Steen-Banasik, Elzbieta, Sundset, Marit, Van Limbergen, Erik, Tan, Li Tee, Lutgens, Ludy C.H.W., Villafranca, Elena, Pieters, Bradley R., Tanderup, Kari, and Kirchheiner, Kathrin

Published
2022

28. Automated causal inference in application to randomized controlled clinical trials

Author

MS Radiotherapie, Cancer, Wu, Ji Q., Horeweg, Nanda, de Bruyn, Marco, Nout, Remi A., Jürgenliemk-Schulz, Ina M., Lutgens, Ludy C.H.W., Jobsen, Jan J., van der Steen-Banasik, Elzbieta M., Nijman, Hans W., Smit, Vincent T.H.B.M., Bosse, Tjalling, Creutzberg, Carien L., Koelzer, Viktor H., MS Radiotherapie, Cancer, Wu, Ji Q., Horeweg, Nanda, de Bruyn, Marco, Nout, Remi A., Jürgenliemk-Schulz, Ina M., Lutgens, Ludy C.H.W., Jobsen, Jan J., van der Steen-Banasik, Elzbieta M., Nijman, Hans W., Smit, Vincent T.H.B.M., Bosse, Tjalling, Creutzberg, Carien L., and Koelzer, Viktor H.

Published
2022

29. Online adaptive MR-guided radiotherapy: Conformity of contour adaptation for prostate cancer, rectal cancer and lymph node oligometastases among radiation therapists and radiation oncologists

Author

Onderzoek Radiotherapie, Cancer, Klinische Fysica RT, MS Radiotherapie, Arts-assistenten Radiotherapie, Rasing, Marnix J A, Sikkes, Gonda G, Vissers, Nicole G P M, Kotte, Alexis N T J, Boudewijn, Joske H, Doornaert, Patricia A H, Eppinga, Wietse S C, Intven, Martijn, Rutgers, Reijer H A, Scheeren, Annick, Snoeren, Louk M W, Vlig, Tiny B, van der Voort van Zyp, Jochem R N, Wijkhuizen, Lisa M, van Rossum, Peter S N, Peters, Max, Jürgenliemk-Schulz, Ina M, Onderzoek Radiotherapie, Cancer, Klinische Fysica RT, MS Radiotherapie, Arts-assistenten Radiotherapie, Rasing, Marnix J A, Sikkes, Gonda G, Vissers, Nicole G P M, Kotte, Alexis N T J, Boudewijn, Joske H, Doornaert, Patricia A H, Eppinga, Wietse S C, Intven, Martijn, Rutgers, Reijer H A, Scheeren, Annick, Snoeren, Louk M W, Vlig, Tiny B, van der Voort van Zyp, Jochem R N, Wijkhuizen, Lisa M, van Rossum, Peter S N, Peters, Max, and Jürgenliemk-Schulz, Ina M

Published
2022

30. Fluorescent Indocyanine Green versus Technetium-99m and Blue Dye for Bilateral SENTinel Lymph Node Detection in Stage I-IIA Cervical Cancer (FluoreSENT): protocol for a non-inferiority study

Author

MS Gynaecologische Oncologie, Cancer, MS Radiologie, Circulatory Health, Pathologie Pathologen staf, MS Radiotherapie, Baeten, Ilse G T, Hoogendam, Jacob P, Braat, Arthur J A T, Veldhuis, Wouter B, Jonges, Geertruida N, Jürgenliemk-Schulz, Ina M, Zweemer, Ronald P, Gerestein, Cornelis G, MS Gynaecologische Oncologie, Cancer, MS Radiologie, Circulatory Health, Pathologie Pathologen staf, MS Radiotherapie, Baeten, Ilse G T, Hoogendam, Jacob P, Braat, Arthur J A T, Veldhuis, Wouter B, Jonges, Geertruida N, Jürgenliemk-Schulz, Ina M, Zweemer, Ronald P, and Gerestein, Cornelis G

Published
2022

31. Impact of magnetic resonance-guided versus conventional radiotherapy workflows on organ at risk doses in stereotactic body radiotherapy for lymph node oligometastases

Author

Cancer, Klinische Fysica RT, Experimentele klinische fysica, Arts-assistenten Radiotherapie, MS Radiotherapie, Werensteijn-Honingh, Anita M, Kroon, Petra S, Winkel, Dennis, van Gaal, J Carlijn, Hes, Jochem, Snoeren, Louk M W, Timmer, Jaleesa K, Mout, Christiaan C P, Bol, Gijsbert H, Kotte, Alexis N, Eppinga, Wietse S C, Intven, Martijn, Raaymakers, Bas W, Jürgenliemk-Schulz, Ina M, Cancer, Klinische Fysica RT, Experimentele klinische fysica, Arts-assistenten Radiotherapie, MS Radiotherapie, Werensteijn-Honingh, Anita M, Kroon, Petra S, Winkel, Dennis, van Gaal, J Carlijn, Hes, Jochem, Snoeren, Louk M W, Timmer, Jaleesa K, Mout, Christiaan C P, Bol, Gijsbert H, Kotte, Alexis N, Eppinga, Wietse S C, Intven, Martijn, Raaymakers, Bas W, and Jürgenliemk-Schulz, Ina M

Published
2022

32. The impact of para-aortic lymph node irradiation on disease-free survival in patients with cervical cancer: A systematic review and meta-analysis

Author

MS Radiotherapie, Cancer, Arts-assistenten Radiotherapie, MS Gynaecologische Oncologie, Bukkems, Leslie J H, Jürgenliemk-Schulz, Ina M, van der Leij, Femke, Peters, Max, Gerestein, Cornelis G, Zweemer, Ronald P, van Rossum, Peter S N, MS Radiotherapie, Cancer, Arts-assistenten Radiotherapie, MS Gynaecologische Oncologie, Bukkems, Leslie J H, Jürgenliemk-Schulz, Ina M, van der Leij, Femke, Peters, Max, Gerestein, Cornelis G, Zweemer, Ronald P, and van Rossum, Peter S N

Published
2022

33. Prognostic impact of waiting time between diagnosis and treatment in patients with cervical cancer: A nationwide population-based study

Author

MS Gynaecologische Oncologie, Cancer, Pathologie Pathologen staf, MS Radiotherapie, Arts-assistenten Radiotherapie, Hack, Amy P., Zweemer, Ronald P., Jonges, Trudy N., van der Leij, Femke, Gerestein, Cornelis G., Peters, Max, Jürgenliemk-Schulz, Ina M., van Rossum, Peter S.N., MS Gynaecologische Oncologie, Cancer, Pathologie Pathologen staf, MS Radiotherapie, Arts-assistenten Radiotherapie, Hack, Amy P., Zweemer, Ronald P., Jonges, Trudy N., van der Leij, Femke, Gerestein, Cornelis G., Peters, Max, Jürgenliemk-Schulz, Ina M., and van Rossum, Peter S.N.

Published
2022

34. Severity and Persistency of Late Gastrointestinal Morbidity in Locally Advanced Cervical Cancer: Lessons Learned From EMBRACE-I and Implications for the Future

Author

MS Radiotherapie, Cancer, Spampinato, Sofia, Jensen, Nina B.K., Pötter, Richard, Fokdal, Lars U., Chargari, Cyrus, Lindegaard, Jacob C., Schmid, Maximilian P., Sturdza, Alina, Jürgenliemk-Schulz, Ina M., Mahantshetty, Umesh, Hoskin, Peter, Segedin, Barbara, Rai, Bhavana, Bruheim, Kjersti, Wiebe, Ericka, Van der Steen-Banasik, Elzbieta, Cooper, Rachel, Van Limbergen, Erik, Sundset, Marit, Pieters, Bradley R., Lutgens, Ludy C.H.W., Tan, Li Tee, Villafranca, Elena, Smet, Stéphanie, Jastaniyah, Noha, Nout, Remi A., Kirisits, Christian, Chopra, Supriya, Kirchheiner, Kathrin, Tanderup, Kari, EMBRACE Collaborative Group, Collaborative Group, MS Radiotherapie, Cancer, Spampinato, Sofia, Jensen, Nina B.K., Pötter, Richard, Fokdal, Lars U., Chargari, Cyrus, Lindegaard, Jacob C., Schmid, Maximilian P., Sturdza, Alina, Jürgenliemk-Schulz, Ina M., Mahantshetty, Umesh, Hoskin, Peter, Segedin, Barbara, Rai, Bhavana, Bruheim, Kjersti, Wiebe, Ericka, Van der Steen-Banasik, Elzbieta, Cooper, Rachel, Van Limbergen, Erik, Sundset, Marit, Pieters, Bradley R., Lutgens, Ludy C.H.W., Tan, Li Tee, Villafranca, Elena, Smet, Stéphanie, Jastaniyah, Noha, Nout, Remi A., Kirisits, Christian, Chopra, Supriya, Kirchheiner, Kathrin, Tanderup, Kari, and EMBRACE Collaborative Group, Collaborative Group

Published
2022

35. Upstaging by para-aortic lymph node dissection in patients with locally advanced cervical cancer: A systematic review and meta-analysis

Author

MS Radiotherapie, Cancer, Arts-assistenten Radiotherapie, MS Gynaecologische Oncologie, Thelissen, Annelou A.B., Jürgenliemk-Schulz, Ina M., van der Leij, Femke, Peters, Max, Gerestein, Cornelis G., Zweemer, Ronald P., van Rossum, Peter S.N., MS Radiotherapie, Cancer, Arts-assistenten Radiotherapie, MS Gynaecologische Oncologie, Thelissen, Annelou A.B., Jürgenliemk-Schulz, Ina M., van der Leij, Femke, Peters, Max, Gerestein, Cornelis G., Zweemer, Ronald P., and van Rossum, Peter S.N.

Published
2022

36. Indocyanine green versus technetium-99m with blue dye for sentinel lymph node detection in early-stage cervical cancer: A systematic review and meta-analysis

Author

MS Gynaecologische Oncologie, Cancer, Arts-assistenten DV&B, Arts Assistenten CTC, Regenerative Medicine and Stem Cells, MS Radiologie, Circulatory Health, MS Radiotherapie, Epi Kanker Team A, JC onderzoeksprogramma Kanker, Baeten, Ilse G.T., Hoogendam, Jacob P., Jeremiasse, Bernadette, Braat, Arthur J.A.T., Veldhuis, Wouter B., Jonges, Geertruida N., Jürgenliemk-Schulz, Ina M., van Gils, Carla H., Zweemer, Ronald P., Gerestein, Cornelis G., MS Gynaecologische Oncologie, Cancer, Arts-assistenten DV&B, Arts Assistenten CTC, Regenerative Medicine and Stem Cells, MS Radiologie, Circulatory Health, MS Radiotherapie, Epi Kanker Team A, JC onderzoeksprogramma Kanker, Baeten, Ilse G.T., Hoogendam, Jacob P., Jeremiasse, Bernadette, Braat, Arthur J.A.T., Veldhuis, Wouter B., Jonges, Geertruida N., Jürgenliemk-Schulz, Ina M., van Gils, Carla H., Zweemer, Ronald P., and Gerestein, Cornelis G.

Published
2022

38. Comparison of Library of Plans with two daily adaptive strategies for whole bladder radiotherapy

Author

den Boer, Duncan, primary, den Hartogh, Mariska D., additional, Kotte, Alexis N.T.J., additional, van der Voort van Zyp, Jochem R.N., additional, Noteboom, Juus L., additional, Bol, Gijsbert H., additional, Willigenburg, Thomas, additional, Werensteijn-Honingh, Anita M., additional, Jürgenliemk-Schulz, Ina M., additional, van Lier, Astrid L.H.M.W., additional, and Kroon, Petra S., additional

Published
2021
Full Text
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39. Indocyanine green versus technetium‐99m with blue dye for sentinel lymph node detection in early‐stage cervical cancer: A systematic review and meta‐analysis

Author

Baeten, Ilse G. T., primary, Hoogendam, Jacob P., additional, Jeremiasse, Bernadette, additional, Braat, Arthur J. A. T., additional, Veldhuis, Wouter B., additional, Jonges, Geertruida N., additional, Jürgenliemk‐Schulz, Ina M., additional, Gils, Carla H., additional, Zweemer, Ronald P., additional, and Gerestein, Cornelis G., additional

Published
2021
Full Text
View/download PDF

40. Long-term toxicity and health-related quality of life after adjuvant chemoradiotherapy or radiotherapy alone for high-risk endometrial cancer in the randomised PORTEC-3 trial

Author

Post, C, de Boer, S, Powell, M, Mileshkin, L, Katsaros, D, Bessette, P, Haie-Meder, C, Ottevanger, N, Ledermann, J, Khaw, P, D'Amico, R, Fyles, A, Baron, M, Kitchener, H, Nijman, H, Lutgens, L, Brooks, S, Jürgenliemk-Schulz, I, Feeney, A, Goss, G, Fossati, R, Ghatage, P, Leary, A, Do, V, Lissoni, A, Mccormack, M, Nout, R, Verhoeven-Adema, K, Smit, V, Putter, H, Creutzberg, C, Post, Cathalijne C B, de Boer, Stephanie M, Powell, Melanie E, Mileshkin, Linda, Katsaros, Dionyssios, Bessette, Paul, Haie-Meder, Christine, Ottevanger, Nelleke P B, Ledermann, Jonathan A, Khaw, Pearly, D'Amico, Romerai, Fyles, Anthony, Baron, Marie Hélène, Kitchener, Henry C, Nijman, Hans W, Lutgens, Ludy C H W, Brooks, Susan, Jürgenliemk-Schulz, Ina M, Feeney, Amanda, Goss, Geraldine, Fossati, Roldano, Ghatage, Prafull, Leary, Alexandra, Do, Viet, Lissoni, Andrea A, McCormack, Mary, Nout, Remi A, Verhoeven-Adema, Karen W, Smit, Vincent T H B M, Putter, Hein, Creutzberg, Carien L, Post, C, de Boer, S, Powell, M, Mileshkin, L, Katsaros, D, Bessette, P, Haie-Meder, C, Ottevanger, N, Ledermann, J, Khaw, P, D'Amico, R, Fyles, A, Baron, M, Kitchener, H, Nijman, H, Lutgens, L, Brooks, S, Jürgenliemk-Schulz, I, Feeney, A, Goss, G, Fossati, R, Ghatage, P, Leary, A, Do, V, Lissoni, A, Mccormack, M, Nout, R, Verhoeven-Adema, K, Smit, V, Putter, H, Creutzberg, C, Post, Cathalijne C B, de Boer, Stephanie M, Powell, Melanie E, Mileshkin, Linda, Katsaros, Dionyssios, Bessette, Paul, Haie-Meder, Christine, Ottevanger, Nelleke P B, Ledermann, Jonathan A, Khaw, Pearly, D'Amico, Romerai, Fyles, Anthony, Baron, Marie Hélène, Kitchener, Henry C, Nijman, Hans W, Lutgens, Ludy C H W, Brooks, Susan, Jürgenliemk-Schulz, Ina M, Feeney, Amanda, Goss, Geraldine, Fossati, Roldano, Ghatage, Prafull, Leary, Alexandra, Do, Viet, Lissoni, Andrea A, McCormack, Mary, Nout, Remi A, Verhoeven-Adema, Karen W, Smit, Vincent T H B M, Putter, Hein, and Creutzberg, Carien L

Abstract

Background: The survival results of the PORTEC-3 trial showed a significant improvement in both overall and failure-free survival with chemoradiotherapy versus pelvic radiotherapy alone. The present analysis was performed to compare long-term adverse events (AE) and health-related quality of life (HRQOL). Patients and methods: 660 women with high-risk endometrial cancer were randomly assigned to receive chemoradiotherapy (2 concurrent cycles of cisplatin followed by 4 cycles of carboplatin/paclitaxel) or radiotherapy alone. Toxicity was graded using CTCAE v3.0. HRQOL was measured using EORTC QLQ-C30 and CX24/OV28-subscales and compared to normative-data. An as-treated analysis was performed. Results: Median follow up was 74.6 months; 574 (87%) patients were evaluable for HRQOL. At 5 years, grade ≥2 AE were scored for 78 (38%) patients who had received chemoradiotherapy versus 46 (24%) who had received radiotherapy (p=0.008). Grade 3 AE did not differ significantly between the groups (8% vs 5%, p=0.18) at 5 years, and only one new late grade 4 toxicity had been reported. At 3 and 5 years, sensory neuropathy toxicity grade ≥2 persisted after chemoradiotherapy in 6% (vs 0% after radiotherapy, p<0.001) and more patients reported significant tingling or numbness at HRQOL (27% vs 8%, p<0.001 at 3 years; 24% vs 9%, p=0.002 at 5 years). Until 3 years, more patients who had chemoradiotherapy reported limb weakness (21% vs 5%, p<0.001) and lower physical (79 vs 87, p<0.001) and role functioning (78 vs 88, p<0.001) scores. Both treatment groups reported similar long-term global health/QOL scores, which were better than those of the normative-population. Conclusion: This study shows a long-lasting, clinically relevant, negative impact of chemoradiotherapy on toxicity and HRQOL, most importantly persistent peripheral sensory neuropathy. Physical and role functioning impairments were seen until 3 years. These long-term data are essential for patient information and

Published
2021

41. Patients' and clinicians' preferences in adjuvant treatment for high-risk endometrial cancer:Implications for shared decision making

Author

Post, Cathalijne C.B., Mens, Jan Willem M., Haverkort, Marie A.D., Koppe, Friederike, Jürgenliemk-Schulz, Ina M., Snyers, An, Roeloffzen, Ellen M.A., Schaake, Eva E., Slot, Annerie, Stam, Tanja C., Beukema, Jannet C., van den Berg, Hetty A., Lutgens, Ludy C.H.W., Nijman, Hans W., de Kroon, Cornelis D., Kroep, Judith R., Stiggelbout, Anne M., Creutzberg, Carien L., Post, Cathalijne C.B., Mens, Jan Willem M., Haverkort, Marie A.D., Koppe, Friederike, Jürgenliemk-Schulz, Ina M., Snyers, An, Roeloffzen, Ellen M.A., Schaake, Eva E., Slot, Annerie, Stam, Tanja C., Beukema, Jannet C., van den Berg, Hetty A., Lutgens, Ludy C.H.W., Nijman, Hans W., de Kroon, Cornelis D., Kroep, Judith R., Stiggelbout, Anne M., and Creutzberg, Carien L.

Abstract

Background: Decision making regarding adjuvant therapy for high-risk endometrial cancer is complex. The aim of this study was to determine patients' and clinicians' minimally desired survival benefit to choose chemoradiotherapy over radiotherapy alone. Moreover, influencing factors and importance of positive and negative treatment effects (i.e. attribute) were investigated. Methods: Patients with high-risk endometrial cancer treated with adjuvant pelvic radiotherapy with or without chemotherapy and multidisciplinary gynaecologic oncology clinicians completed a trade-off questionnaire based on PORTEC-3 trial data. Results: In total, 171 patients and 63 clinicians completed the questionnaire. Median minimally desired benefit to make chemoradiotherapy worthwhile was significantly higher for patients versus clinicians (10% vs 5%, p = 0.02). Both patients and clinicians rated survival benefit most important during decision making, followed by long-term symptoms. Older patients (OR 0.92 [95%CI 0.87–0.97]; p = 0.003) with comorbidity (OR 0.34 [95% CI 0.12–0.89]; p = 0.035) had lower preference for chemoradiotherapy, while patients with better numeracy skills (OR 1.2 [95%CI 1.05–1.36], p = 0.011) and chemoradiotherapy history (OR 25.0 [95%CI 8.8–91.7]; p < 0.001) had higher preference for chemoradiotherapy. Conclusions: There is a considerable difference in minimally desired survival benefit of chemoradiotherapy in high-risk endometrial cancer among and between patients and clinicians. Overall, endometrial cancer patients needed higher benefits than clinicians before preferring chemoradiotherapy.

Published
2021

42. Patients' and clinicians' preferences in adjuvant treatment for high-risk endometrial cancer: Implications for shared decision making

Author

MS Radiotherapie, Cancer, Post, Cathalijne C.B., Mens, Jan Willem M., Haverkort, Marie A.D., Koppe, Friederike, Jürgenliemk-Schulz, Ina M., Snyers, An, Roeloffzen, Ellen M.A., Schaake, Eva E., Slot, Annerie, Stam, Tanja C., Beukema, Jannet C., van den Berg, Hetty A., Lutgens, Ludy C.H.W., Nijman, Hans W., de Kroon, Cornelis D., Kroep, Judith R., Stiggelbout, Anne M., Creutzberg, Carien L., MS Radiotherapie, Cancer, Post, Cathalijne C.B., Mens, Jan Willem M., Haverkort, Marie A.D., Koppe, Friederike, Jürgenliemk-Schulz, Ina M., Snyers, An, Roeloffzen, Ellen M.A., Schaake, Eva E., Slot, Annerie, Stam, Tanja C., Beukema, Jannet C., van den Berg, Hetty A., Lutgens, Ludy C.H.W., Nijman, Hans W., de Kroon, Cornelis D., Kroep, Judith R., Stiggelbout, Anne M., and Creutzberg, Carien L.

Published
2021

43. Risk factors and dose-effects for bladder fistula, bleeding and cystitis after radiotherapy with imaged-guided adaptive brachytherapy for cervical cancer: An EMBRACE analysis

Author

MS Radiotherapie, Cancer, Spampinato, Sofia, Fokdal, Lars U., Pötter, Richard, Haie-Meder, Christine, Lindegaard, Jacob C., Schmid, Maximilian P., Sturdza, Alina, Jürgenliemk-Schulz, Ina M., Mahantshetty, Umesh, Segedin, Barbara, Bruheim, Kjersti, Hoskin, Peter, Rai, Bhavana, Huang, Fleur, Cooper, Rachel, van der Steen-Banasik, Elzbieta, Van Limbergen, Erik, Sundset, Marit, Westerveld, Henrike, Nout, Remi A., Jensen, Nina B.K., Kirisits, Christian, Kirchheiner, Kathrin, Tanderup, Kari, MS Radiotherapie, Cancer, Spampinato, Sofia, Fokdal, Lars U., Pötter, Richard, Haie-Meder, Christine, Lindegaard, Jacob C., Schmid, Maximilian P., Sturdza, Alina, Jürgenliemk-Schulz, Ina M., Mahantshetty, Umesh, Segedin, Barbara, Bruheim, Kjersti, Hoskin, Peter, Rai, Bhavana, Huang, Fleur, Cooper, Rachel, van der Steen-Banasik, Elzbieta, Van Limbergen, Erik, Sundset, Marit, Westerveld, Henrike, Nout, Remi A., Jensen, Nina B.K., Kirisits, Christian, Kirchheiner, Kathrin, and Tanderup, Kari

Published
2021

44. Results of image guided brachytherapy for stage IB cervical cancer in the RetroEMBRACE study

Author

MS Radiotherapie, Cancer, Petric, Primoz, Lindegaard, Jacob C., Sturdza, Alina, Fokdal, Lars, Kirchheiner, Kathrin, Tan, Li T., Schmid, Maximilian P., Haie-Meder, Christine, Jürgenliemk-Schulz, Ina M., van Limbergen, Erik, Hoskin, Peter, Gillham, Charles, Tharavichitkul, Ekkasit, Mahantshetty, Umesh, Villafranca, Elena, Tanderup, Kari, Kirisits, Christian, Pötter, Richard, MS Radiotherapie, Cancer, Petric, Primoz, Lindegaard, Jacob C., Sturdza, Alina, Fokdal, Lars, Kirchheiner, Kathrin, Tan, Li T., Schmid, Maximilian P., Haie-Meder, Christine, Jürgenliemk-Schulz, Ina M., van Limbergen, Erik, Hoskin, Peter, Gillham, Charles, Tharavichitkul, Ekkasit, Mahantshetty, Umesh, Villafranca, Elena, Tanderup, Kari, Kirisits, Christian, and Pötter, Richard

Published
2021

45. Long-Term Toxicity and Health-Related Quality of Life After Adjuvant Chemoradiation Therapy or Radiation Therapy Alone for High-Risk Endometrial Cancer in the Randomized PORTEC-3 Trial

Author

MS Radiotherapie, Cancer, Post, Cathalijne C.B., de Boer, Stephanie M., Powell, Melanie E., Mileshkin, Linda, Katsaros, Dionyssios, Bessette, Paul, Haie-Meder, Christine, Ottevanger, Nelleke (P ).B., Ledermann, Jonathan A., Khaw, Pearly, D'Amico, Romerai, Fyles, Anthony, Baron, Marie Hélène, Kitchener, Henry C., Nijman, Hans W., Lutgens, Ludy C.H.W., Brooks, Susan, Jürgenliemk-Schulz, Ina M., Feeney, Amanda, Goss, Geraldine, Fossati, Roldano, Ghatage, Prafull, Leary, Alexandra, Do, Viet, Lissoni, Andrea A., McCormack, Mary, Nout, Remi A., Verhoeven-Adema, Karen W., Smit, Vincent T.H.B.M., Putter, Hein, Creutzberg, Carien L., MS Radiotherapie, Cancer, Post, Cathalijne C.B., de Boer, Stephanie M., Powell, Melanie E., Mileshkin, Linda, Katsaros, Dionyssios, Bessette, Paul, Haie-Meder, Christine, Ottevanger, Nelleke (P ).B., Ledermann, Jonathan A., Khaw, Pearly, D'Amico, Romerai, Fyles, Anthony, Baron, Marie Hélène, Kitchener, Henry C., Nijman, Hans W., Lutgens, Ludy C.H.W., Brooks, Susan, Jürgenliemk-Schulz, Ina M., Feeney, Amanda, Goss, Geraldine, Fossati, Roldano, Ghatage, Prafull, Leary, Alexandra, Do, Viet, Lissoni, Andrea A., McCormack, Mary, Nout, Remi A., Verhoeven-Adema, Karen W., Smit, Vincent T.H.B.M., Putter, Hein, and Creutzberg, Carien L.

Published
2021

46. Response to Yuce Sari et al.

Author

MS Radiotherapie, Cancer, Spampinato, Sofia, Fokdal, Lars U., Pötter, Richard, Haie-Meder, Christine, Lindegaard, Jacob C., Schmid, Maximilian P., Sturdza, Alina, Jürgenliemk-Schulz, Ina M., Mahantshetty, Umesh, Segedin, Barbara, Bruheim, Kjersti, Hoskin, Peter, Rai, Bhavana, Huang, Fleur, Cooper, Rachel, van der Steen-Banasik, Elzbieta, Van Limbergen, Erik, Sundset, Marit, Westerveld, Henrike, Nout, Remi A., Jensen, Nina B.K., Kirisits, Christian, Kirchheiner, Kathrin, Tanderup, Kari, MS Radiotherapie, Cancer, Spampinato, Sofia, Fokdal, Lars U., Pötter, Richard, Haie-Meder, Christine, Lindegaard, Jacob C., Schmid, Maximilian P., Sturdza, Alina, Jürgenliemk-Schulz, Ina M., Mahantshetty, Umesh, Segedin, Barbara, Bruheim, Kjersti, Hoskin, Peter, Rai, Bhavana, Huang, Fleur, Cooper, Rachel, van der Steen-Banasik, Elzbieta, Van Limbergen, Erik, Sundset, Marit, Westerveld, Henrike, Nout, Remi A., Jensen, Nina B.K., Kirisits, Christian, Kirchheiner, Kathrin, and Tanderup, Kari

Published
2021

47. Prevalence and Prognosis of Lynch Syndrome and Sporadic Mismatch Repair Deficiency in Endometrial Cancer

Author

MS Radiotherapie, Cancer, Post, Cathalijne C.B., Stelloo, Ellen, Smit, Vincent T.H.B.M., Ruano, Dina, Tops, Carli M., Vermij, Lisa, Rutten, Tessa A., Jürgenliemk-Schulz, Ina M., Lutgens, Ludy C.H.W., Jobsen, Jan J., Nout, Remi A., Crosbie, Emma J., Powell, Melanie E., Mileshkin, Linda, Leary, Alexandra, Bessette, Paul, Putter, Hein, de Boer, Stephanie M., Horeweg, Nanda, Nielsen, Maartje, Wezel, Tom van, Bosse, Tjalling, Creutzberg, Carien L., MS Radiotherapie, Cancer, Post, Cathalijne C.B., Stelloo, Ellen, Smit, Vincent T.H.B.M., Ruano, Dina, Tops, Carli M., Vermij, Lisa, Rutten, Tessa A., Jürgenliemk-Schulz, Ina M., Lutgens, Ludy C.H.W., Jobsen, Jan J., Nout, Remi A., Crosbie, Emma J., Powell, Melanie E., Mileshkin, Linda, Leary, Alexandra, Bessette, Paul, Putter, Hein, de Boer, Stephanie M., Horeweg, Nanda, Nielsen, Maartje, Wezel, Tom van, Bosse, Tjalling, and Creutzberg, Carien L.

Published
2021

49. Comparison of Library of Plans with two daily adaptive strategies for whole bladder radiotherapy

Author

Radiotherapie, Klinische Fysica RT, Cancer, MS Radiotherapie, Arts-assistenten Radiotherapie, Onderzoek Radiotherapie, den Boer, Duncan, den Hartogh, Mariska D., Kotte, Alexis N.T.J., van der Voort van Zyp, Jochem R.N., Noteboom, Juus L., Bol, Gijsbert H., Willigenburg, Thomas, Werensteijn-Honingh, Anita M., Jürgenliemk-Schulz, Ina M., van Lier, Astrid L.H.M.W., Kroon, Petra S., Radiotherapie, Klinische Fysica RT, Cancer, MS Radiotherapie, Arts-assistenten Radiotherapie, Onderzoek Radiotherapie, den Boer, Duncan, den Hartogh, Mariska D., Kotte, Alexis N.T.J., van der Voort van Zyp, Jochem R.N., Noteboom, Juus L., Bol, Gijsbert H., Willigenburg, Thomas, Werensteijn-Honingh, Anita M., Jürgenliemk-Schulz, Ina M., van Lier, Astrid L.H.M.W., and Kroon, Petra S.

Published
2021

50. Progression-free survival in patients with Ga-68-PSMA-PET-directed SBRT for lymph node oligometastases

Author

Onderzoek Radiotherapie, Cancer, Arts-assistenten Radiotherapie, Klinische Fysica RT, MS Radiotherapie, Werensteijn-Honingh, Anita M, Wevers, Anne F J, Peters, Max, Kroon, Petra S, Intven, Martijn, Eppinga, Wietse S C, Jürgenliemk-Schulz, Ina M, Onderzoek Radiotherapie, Cancer, Arts-assistenten Radiotherapie, Klinische Fysica RT, MS Radiotherapie, Werensteijn-Honingh, Anita M, Wevers, Anne F J, Peters, Max, Kroon, Petra S, Intven, Martijn, Eppinga, Wietse S C, and Jürgenliemk-Schulz, Ina M

Published
2021

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