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204. Breast Edema Following Breast-Conserving Surgery and Radiotherapy: Patient-Reported Prevalence, Determinants, and Effect on Health-Related Quality of Life

Author

Young-Afat, Danny A, primary, Gregorowitsch, Madelijn L, additional, van den Bongard, Desirée H, additional, Burgmans, Ine, additional, van der Pol, Carmen C, additional, Witkamp, Arjen J, additional, Bijlsma, Rhodé M, additional, Koelemij, Ron, additional, Schoenmaeckers, Ernst J, additional, Jonasse, Yvette, additional, van Gils, Carla H, additional, and Verkooijen, Helena M, additional

Published
2019
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207. Health-related quality of life in rectal cancer patients undergoing neoadjuvant chemoradiation with delayed surgery versus short-course radiotherapy with immediate surgery: a propensity score-matched cohort study

Author

Couwenberg, Alice M., primary, Burbach, Johannes P. M., additional, Intven, Martijn P. W., additional, Consten, Esther C. J., additional, Schiphorst, Anandi H. W., additional, Smits, Anke B., additional, Wijffels, Niels A. T., additional, Heikens, Joost T., additional, Koopman, Miriam, additional, van Grevenstein, Wilhemina M. U., additional, and Verkooijen, Helena M., additional

Published
2019
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212. Remarkable change in age-specific breast cancer incidence in the Swiss canton of Geneva and its possible relation with the use of hormone replacement therapy

Author

Wespi Yves, Fioretta Gérald, Verkooijen Helena M, Morabia Alfredo, Bouchardy Christine, and Schäfer Peter

Subjects
Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Abstract Background This article aims to explain the reasons for the remarkable change in age of breast cancer occurrence in the Swiss canton of Geneva. Methods We used population-based data from the Geneva cancer registry, which collects information on method of detection, stage and tumour characteristics since 1975. For patients diagnosed between 1997–2003, we obtained additional information on use of hormone replacement therapy from a large prospective study on breast cancer. Using generalized log linear regression analysis, we compared age-specific incidence rates with respect to period, stage, oestrogen receptor status, method of detection and use of hormone replacement therapy. Results In the periods 1975–1979 and 1985–1989, breast cancer risk increased with age, showing the highest incidence rates among women aged ≥ 85 years. From 1997, the age-specific incidence curve changed completely (p < 0.0001), showing an incidence peak at 60–64 years and a reduced incidence among elderly women. This incidence peak concerned mainly early stage and oestrogen positive cancers and was exclusively observed among women who ever used hormone replacement therapy, regardless whether the tumour was screen-detected or not. Conclusion The increasing prevalence of hormone replacement therapy use during the 1990s could explain the important change in age-specific breast cancer incidence, not only by increasing breast cancer risk, but also by revealing breast cancer at an earlier age.

Published
2006
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214. The ethics of ‘Trials within Cohorts’ (TwiCs): 2nd international symposium

Author

Relton, Clare, Burbach, Maarten, Collett, Clive, Flory, James, Gerlich, Sophie, Holm, Soren, Hunn, Amanda, Kim, Scott Y., Kwakkenbos, Linda, May, Anne, Nicholl, Jon, Young-Afat, Danny, Treweek, Shaun, Uher, Rudolf, van Staa, Tjeerd, van der Velden, Joanne, Verkooijen, Helena, Vickers, Andrew, Welch, Sophie, Zwarenstein, Merrick, Kim, Scott, Goodman, Zachary, Holm, Søren, May, Anne M., Young-Afat, Danny A., Burbach, Johannes P., van Gils, Carla H., van der Graaf, Rieke, Verkooijen, Helena M., Coates, Laura C., Tillett, William, Torgerson, David, McHugh, Neil, Taylor, Peter, Brown, Lesley, Heaven, Anne, Young, John, Clegg, Andrew, Chatfield, Kate, Gal, Roxanne, Monninkhof, Evelyn M., Afat, Danny A. Young, Groenwold, Rolf H. H., Carrier, Marie-Eve, Thombs, Brett D., van der Velden, Joanne M., Gerlich, A. Sophie, Verlaan, Jorrit-Jan, Couwenberg, Alice M., Burbach, Johannes P. M., Peckham, Emily, Crossland, Suzanne, Hughes, Tom, O’Connor, Alisha, Sargent, Imogen, and Gilbody, Simon

Subjects
Meeting Abstracts
Published
2017

215. R-IDEAL: A Framework for Systematic Clinical Evaluation of Technical Innovations in Radiation Oncology

Author

Verkooijen, Helena M., Kerkmeijer, Linda G. W., Fuller, Clifton D., Huddart, Robbert, Faivre-Finn, Corinne, Verheij, Marcel, Mook, Stella, Sahgal, Arjun, Hall, Emma, and Schultz, Chris

Subjects
evaluation, Oncology, MRI-guided linear accelerator, design, methodology, innovation
Abstract

The pace of innovation in radiation oncology is high and the window of opportunity for evaluation narrow. Financial incentives, industry pressure, and patients’ demand for high-tech treatments have led to widespread implementation of innovations before, or even without, robust evidence of improved outcomes has been generated. The standard phase I–IV framework for drug evaluation is not the most efficient and desirable framework for assessment of technological innovations. In order to provide a standard assessment methodology for clinical evaluation of innovations in radiotherapy, we adapted the surgical IDEAL framework to fit the radiation oncology setting. Like surgery, clinical evaluation of innovations in radiation oncology is complicated by continuous technical development, team and operator dependence, and differences in quality control. Contrary to surgery, radiotherapy innovations may be used in various ways, e.g., at different tumor sites and with different aims, such as radiation volume reduction and dose escalation. Also, the effect of radiation treatment can be modeled, allowing better prediction of potential benefits and improved patient selection. Key distinctive features of R-IDEAL include the important role of predicate and modeling studies (Stage 0), randomization at an early stage in the development of the technology, and long-term follow-up for late toxicity. We implemented R-IDEAL for clinical evaluation of a recent innovation in radiation oncology, the MRI-guided linear accelerator (MR-Linac). MR-Linac combines a radiotherapy linear accelerator with a 1.5-T MRI, aiming for improved targeting, dose escalation, and margin reduction, and is expected to increase the use of hypofractionation, improve tumor control, leading to higher cure rates and less toxicity. An international consortium, with participants from seven large cancer institutes from Europe and North America, has adopted the R-IDEAL framework to work toward coordinated, evidence-based introduction of the MR-Linac. R-IDEAL holds the promise for timely, evidence-based introduction of radiotherapy innovations with proven superior effectiveness, while preventing unnecessary exposure of patients to potentially harmful interventions.

Published
2017
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216. Julius Symposium 2017 - Gal, R

Author

Gal, Roxanne, Monninkhof, Evelyn M., Verkooijen, Helena M., Gils, Carla H. Van, Groenwold, Rolf H.H., Bongard, Desirée H.J.G. Van Den, Peeters, Petra H.M., and May, Anne M.

Abstract

The cohort multiple randomized controlled trial (cmRCT) design in exercise-oncology: First experiences

Published
2017
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217. Effect of Neoadjuvant Therapy and Rectal Surgery on Health-related Quality of Life in Patients With Rectal Cancer During the First 2 Years After Diagnosis

Author

Couwenberg, Alice M., primary, Burbach, Johannes P.M., additional, van Grevenstein, Wilhelmina M.U., additional, Smits, Anke B., additional, Consten, Esther C.J., additional, Schiphorst, Anandi H.W., additional, Wijffels, Niels A.T., additional, Heikens, Joost T., additional, Intven, Martijn P.W., additional, and Verkooijen, Helena M., additional

Published
2018
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218. Protocol for a scoping review to support development of a CONSORT extension for randomised controlled trials using cohorts and routinely collected health data

Author

Kwakkenbos, Linda, primary, Imran, Mahrukh, additional, McCord, Kimberly A, additional, Sampson, Margaret, additional, Fröbert, Ole, additional, Gale, Chris, additional, Hemkens, Lars G, additional, Langan, Sinead M, additional, Moher, David, additional, Relton, Clare, additional, Zwarenstein, Merrick, additional, Benchimol, Eric I, additional, Boutron, Isabelle, additional, Campbell, Marion K, additional, Erlinge, David, additional, Jawad, Sena, additional, Ravaud, Philippe, additional, Rice, Danielle B, additional, Sauve, Maureen, additional, van Staa, Tjeerd P, additional, Thabane, Lehana, additional, Uher, Rudolf, additional, Verkooijen, Helena M, additional, Juszczak, Edmund, additional, and Thombs, Brett D, additional

Published
2018
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220. Management of MEN1 Related Nonfunctioning Pancreatic NETs: A Shifting Paradigm

Author

Nell, Sjoerd, primary, Verkooijen, Helena M., additional, Pieterman, Carolina R. C., additional, de Herder, Wouter W., additional, Hermus, Ad R., additional, Dekkers, Olaf M., additional, van der Horst-Schrivers, Anouk N., additional, Drent, Madeleine L., additional, Bisschop, Peter H., additional, Havekes, Bas, additional, Borel Rinkes, Inne H. M., additional, Vriens, Menno R., additional, and Valk, Gerlof D., additional

Published
2018
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221. Automatic quantification of calcifications in the coronary arteries and thoracic aorta on radiotherapy planning CT scans of Western and Asian breast cancer patients

Author

Gernaat, Sofie A.M., primary, van Velzen, Sanne G.M., additional, Koh, Vicky, additional, Emaus, Marleen J., additional, Išgum, Ivana, additional, Lessmann, Nikolas, additional, Moes, Shinta, additional, Jacobson, Anouk, additional, Tan, Poey W., additional, Grobbee, Diederick E., additional, van den Bongard, Desiree H.J., additional, Tang, Johann I., additional, and Verkooijen, Helena M., additional

Published
2018
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224. The impact of postoperative complications on health-related quality of life in older patients with rectal cancer; a prospective cohort study

Author

Couwenberg, Alice M., primary, de Beer, Fleur S.A., additional, Intven, Martijn P.W., additional, Burbach, Johannes P.M., additional, Smits, Anke B., additional, Consten, Esther C.J., additional, Schiphorst, Anandi H.W., additional, Wijffels, Niels A.T., additional, de Roos, Marnix A.J., additional, Hamaker, Marije E., additional, van Grevenstein, Wilhemina M.U., additional, and Verkooijen, Helena M., additional

Published
2018
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227. Early and Late Complications After Surgery for MEN1-related Nonfunctioning Pancreatic Neuroendocrine Tumors

Author

Nell, Sjoerd, primary, Borel Rinkes, Inne H. M., additional, Verkooijen, Helena M., additional, Bonsing, Bert A., additional, van Eijck, Casper H., additional, van Goor, Harry, additional, de Kleine, Ruben H. J., additional, Kazemier, Geert, additional, Nieveen van Dijkum, Elisabeth J., additional, Dejong, Cornelis H. C., additional, Valk, Gerlof D., additional, and Vriens, Menno R., additional

Published
2018
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229. Development and Internal Validation of a Clinical Risk Score to Predict Pain Response After Palliative Radiation Therapy in Patients With Bone Metastases

Author

van der Velden, Joanne M., primary, Peters, Max, additional, Verlaan, Jorrit-Jan, additional, Versteeg, Anne L., additional, Zhang, Liying, additional, Tsao, May, additional, Danjoux, Cyril, additional, Barnes, Elizabeth, additional, van Vulpen, Marco, additional, Chow, Edward, additional, and Verkooijen, Helena M., additional

Published
2017
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232. The MRI-Linear Accelerator Consortium : Evidence-Based Clinical Introduction of an Innovation in Radiation Oncology Connecting Researchers, Methodology, Data Collection, Quality Assurance, and Technical Development

Author

Kerkmeijer, LGW, Fuller, Clifton D, Verkooijen, Helena M, Verheij, Marcel, Choudhury, Ananya, Harrington, Kevin J, Schultz, Chris, Sahgal, Arjun, Frank, Steven J, Goldwein, Joel, Brown, Kevin J, Minsky, Bruce D, van Vulpen, Marco, and MR-Linac Consortium Clinical Steering Committee

Subjects
Journal Article
Abstract

An international research consortium has been formed to facilitate evidence-based introduction of MR-guided radiotherapy (MR-linac) and to address how the MR-linac could be used to achieve an optimized radiation treatment approach to improve patients' survival, local, and regional tumor control and quality of life. The present paper describes the organizational structure of the clinical part of the MR-linac consortium. Furthermore, it elucidates why collaboration on this large project is necessary, and how a central data registry program will be implemented.

Published
2016

233. Supine MRI for regional breast radiotherapy: imaging axillary lymph nodes before and after sentinel-node biopsy

Author

van Heijst, Tristan C F, primary, Eschbach-Zandbergen, Debora, additional, Hoekstra, Nienke, additional, van Asselen, Bram, additional, Lagendijk, Jan J W, additional, Verkooijen, Helena M, additional, Pijnappel, Ruud M, additional, de Waard, Stephanie N, additional, Witkamp, Arjen J, additional, van Dalen, Thijs, additional, van den Bongard, H J G Desirée, additional, and Philippens, Marielle E P, additional

Published
2017
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237. Automatic Coronary Artery Calcium Scoring on Radiotherapy Planning CT Scans of Breast Cancer Patients: Reproducibility and Association with Traditional Cardiovascular Risk Factors

Author

Gernaat, Sofie A. M., primary, Išgum, Ivana, additional, de Vos, Bob D., additional, Takx, Richard A. P., additional, Young-Afat, Danny A., additional, Rijnberg, Noor, additional, Grobbee, Diederick E., additional, van der Graaf, Yolanda, additional, de Jong, Pim A., additional, Leiner, Tim, additional, van den Bongard, Desiree H. J., additional, Pignol, Jean-Philippe, additional, and Verkooijen, Helena M., additional

Published
2016
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238. Comparing conVEntional RadioTherapy with stereotactIC body radiotherapy in patients with spinAL metastases: study protocol for an randomized controlled trial following the cohort multiple randomized controlled trial design

Author

van der Velden, Joanne M., primary, Verkooijen, Helena M., additional, Seravalli, Enrica, additional, Hes, Jochem, additional, Gerlich, A. Sophie, additional, Kasperts, Nicolien, additional, Eppinga, Wietse S. C., additional, Verlaan, Jorrit-Jan, additional, and van Vulpen, Marco, additional

Published
2016
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241. Deep Learning for Automatic Calcium Scoring in CT: Validation Using Multiple Cardiac CT and Chest CT Protocols

Author

Velzen, Sanne G. M. van, Lessmann, Nikolas, Velthuis, Birgitta K., Bank, Ingrid E. M., Bongard, Desiree H. J. G. van den, Leiner, Tim, Jong, Pim A. de, Veldhuis, Wouter B., Correa, Adolfo, Terry, James G., Carr, John Jeffrey, Viergever, Max A., Verkooijen, Helena M., and Išgum, Ivana

Abstract

A deep learning calcium scoring method can accurately determine cardiovascular risk from a range of CT scan protocols.

Published
2020
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242. The effect of time interval from chemoradiation to surgery on postoperative complications in patients with rectal cancer.

Author

Couwenberg, Alice M., Intven, Martijn P.W., Hoendervangers, Sieske, van der Sluis, Frederik J., van Westreenen, Henderik L., Marijnen, Corrie A.M., van Grevenstein, Wilhelmina M.U., and Verkooijen, Helena M.

Subjects
SURGICAL complications, RECTAL cancer, CHEMORADIOTHERAPY, RADIOTHERAPY, CANCER patients, ODDS ratio
Abstract

A prolonged time interval between chemoradiation and total mesorectal excision (TME) may render more rectal cancer patients eligible for organ-sparing approaches but may also cause more pelvic fibrosis and surgical morbidity. We estimated the effect of time interval on postoperative complications and other surgical outcomes in rectal cancer patients. This is a population-based cohort study using data of the Dutch Colorectal Audit. Rectal cancer patients treated with chemoradiation followed by TME after an interval of 3–20 weeks were selected (n = 6,268). Time interval from completion of chemoradiation to TME was categorized into 3–6, 7–8, 9–10, 11–12 and 13–20 weeks. Outcomes included postoperative complication (any, and stratified by medical and surgical complications), reintervention, intraoperative complication, incomplete resection, positive circumferential margin (CRM) and pathological complete response (pCR). The interval of 7–8 weeks was the reference group. Prolonged time intervals were not associated with a higher risk of a postoperative complication (any, surgical or medical), reintervention, and incomplete resection. Intraoperative complications were however more common after 11–12 weeks than after 7–8 weeks (odds ratio (OR) = 1.79, 95% confidence interval (CI) = 1.20–2.69). The interval of 9–10 weeks was associated with less CRM positive resections, and 9–10 and 13–20 weeks with more pCR (relative to 7–8 weeks, OR = 0.74, 95%CI = 0.56–0.98; OR = 1.28, 95%CI = 1.04–1.58; and OR = 1.33, 95%CI = 1.04–1.71, respectively). Compared with 7–8 weeks, longer time intervals up to 13–20 weeks between chemoradiation and TME are not associated with more postoperative complications or more positive resection margins. Accordingly, prolonging the interval aiming for organ-sparing treatment is safe. [ABSTRACT FROM AUTHOR]

Published
2019
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243. Impact of modern-day axillary treatment on patient reported arm morbidity and physical functioning in breast cancer patients.

Author

Gregorowitsch, Madelijn L., Verkooijen, Helena M., Houweling, Anette, Fuhler, Nick, Koelemij, Ron, Schoenmaeckers, Ernst J.P., Sier, Maartje F., Ernst, Miranda F., Witkamp, Arjen J., Van Dalen, Thijs, Young-Afat, Danny A., and van den Bongard, Desiree H.J.G.

Subjects
*SENTINEL lymph node biopsy, *AXILLARY lymph node dissection, *BREAST cancer, *ARM, *CANCER patients
Abstract

Abstract Purpose To reduce arm morbidity, routine axillary lymph node dissection (ALND) is often omitted or replaced by axillary radiotherapy (AxRT) in patients with limited nodal involvement. We evaluated patient-reported arm morbidity and physical functioning in breast cancer patients undergoing modern-day axillary treatment. Methods All patients within the UMBRELLA cohort undergoing local radiotherapy with sentinel lymph node biopsy (SLNB), ALND and/or AxRT were selected. Patient-reported arm morbidity and physical functioning were assessed with EORTC QLQ C30/BR23 questionnaires up to eighteen months after initiation of radiotherapy. Patient-reported outcomes were compared between patients with SLNB only, ALND only, AxRT (level I–II), AxRT (level I–IV) or AxRT plus ALND by means of mixed model analysis. Results In total, 949 patients were identified; 641 (68%) SLNB only, 57 (6%) ALND only, 94 (10%) AxRT level I–II, 72 (8%) AxRT level I–IV and 85 (9%) ALND + AxRT. SLNB only resulted in the least arm morbidity scores. ALND + AxRT resulted in most arm morbidity, with clinically relevant differences at 18 months. AxRT (level I–II or level I–IV) resulted in significantly less arm symptoms in the first 3 months compared to ALND. Arm symptom scores between those receiving AxRT on levels I–II and I–IV were similar. Conclusion Of all axillary management strategies, ALND plus AxRT is associated with worst patient-reported outcomes. AxRT resulted in less arm morbidity compared to ALND. Selective radiotherapy treatment of the axilla, i.e. radiotherapy of levels I–II only instead of levels I–IV, did not lead to clinically relevant reduced arm morbidity. [ABSTRACT FROM AUTHOR]

Published
2019
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245. Prognostic models in male breast cancer

Author

van der Pol, Carmen C., primary, Lacle, Miangela M., additional, Witkamp, Arjen J., additional, Kornegoor, Robert, additional, Miao, Hui, additional, Bouchardy, Christine, additional, Borel Rinkes, Inne, additional, van der Wall, Elsken, additional, Verkooijen, Helena M., additional, and van Diest, Paul J., additional

Published
2016
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246. High Prevalence of MRI-Detected Contralateral and Ipsilateral Malignant Findings in Patients With Invasive Ductolobular Breast Cancer: Impact on Surgical Management

Author

El Sharouni, Mary-Ann, primary, Postma, Emily L., additional, Menezes, Gisela L.G., additional, van den Bosch, Maurice A.A.J., additional, Pijnappel, Ruud M., additional, Witkamp, Arjen J., additional, van der Pol, Carmen C., additional, Verkooijen, Helena M., additional, and van Diest, Paul J., additional

Published
2016
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247. Abstract 1827: The prospective Dutch colorectal cancer cohort: A prospective nation-wide observational cohort study

Author

Coebergh van den Braak, Robert R.J., primary, Vink, Geraldine R., additional, van Oijen, Martijn G.H., additional, de Noo, Mirre E., additional, Kurk, Sophie A., additional, Burbach, Maarten J.P., additional, Couwenberg, Alice M., additional, May, Anne M., additional, Verkooijen, Helena M., additional, Meijer, Gerrit A., additional, and Koopman, Miriam, additional

Published
2016
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248. Patients’ and Health Care Providers’ Opinions on a Supportive Health App During Breast Cancer Treatment: A Qualitative Evaluation

Author

Young-Afat, Danny A, primary, van Gils, Carla H, additional, Bruinvels, David J, additional, van der Pol, Carmen C, additional, Witkamp, Arjen J, additional, Sijtsema, Sieta, additional, Jonasse, Yvette, additional, Bijlsma, Rhodé M, additional, Ausems, Margreet G, additional, Bos, Annelies M, additional, van den Bongard, Desirée H, additional, and Verkooijen, Helena M, additional

Published
2016
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