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1. Gloss, Color and Topography Scanning for Reproducing a Painting's Appearance using 3D printing

Author

Elkhuizen, Willemijn, Essers, Tessa, Song, Yu, Geraedts, Jo, Weijkamp, Clemens, Dik, Joris, and Pont, Sylvia

Subjects
Computer Science - Graphics, Electrical Engineering and Systems Science - Image and Video Processing
Abstract

High fidelity reproductions of paintings provide new opportunities to museums in preserving and providing access to cultural heritage. This paper presents an integrated system which is able to capture and fabricate color, topography and gloss of a painting, of which gloss capturing forms the most important contribution. A 3D imaging system, using fringe-encoded stereo imaging, is extended to capture spatially-varying gloss, utilizing specular reflectance polarization. The gloss is measured by sampling the specular reflection around Brewster's angle, where these reflections are effectively polarized, and can be separated from the unpolarized, diffuse reflectance. Off-center gloss measurements are calibrated relative to the center measurement. Off-specular gloss measurements, following from local variation of the surface normal, are masked based on the height map and corrected. Shadowed regions, caused by the 3D relief, are treated similarly. The area of a single capture is approximately 180x90mm at a resolution of 25x25micron. Aligned color, height, and gloss tiles are stitched together, registering overlapping color areas. These maps are inputs for a 3D printer. Two paintings were reproduced to verify the effectiveness and efficiency of the proposed system. One painting was scanned four times, consecutively rotated by 90 degrees, to evaluate the influence of the scanning system geometric configuration on the gloss measurement. Experimental results show that the method is sufficiently fast for practical application. The results can well be used for the purpose of physical reproduction and other applications needing first-order estimates of the appearance. Our method to extend appearance scanning with gloss measurements is a valuable addition in the quest for realistic reproductions, in terms of its practical applicability and its perceptual added value, when added to color and topography.

Published
2019

2. Hatching for 3D prints: line-based halftoning for dual extrusion fused deposition modeling

Author

Kuipers, Tim, Elkhuizen, Willemijn, Verlinden, Jouke, and Doubrovski, Eugeni

Subjects
Computer Science - Graphics, J.6
Abstract

This work presents a halftoning technique to manufacture 3D objects with the appearance of continuous grayscale imagery for Fused Deposition Modeling (FDM) printers. While droplet-based dithering is a common halftoning technique, this is not applicable to FDM printing, since FDM builds up objects by extruding material in semi-continuous paths. The line-based halftoning principle called 'hatching' is applied to the line patterns naturally occuring in FDM prints, which are built up in a layer-by-layer fashion. The proposed halftoning technique isn't limited by the challenges existing techniques face; existing FDM coloring techniques greatly influence the surface geometry and deteriorate with surface slopes deviating from vertical or greatly influence the basic parameters of the printing process and thereby the structural properties of the resulting product. Furthermore, the proposed technique has little effect on printing time. Experiments on a dual-nozzle FDM printer show promising results. Future work is required to calibrate the perceived tone., Comment: 12 pages, 14 figures

Published
2018
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4. Mammatumoren

Author

Liefers, G. J., Scholten, A. N., Elkhuizen, P. H. M., Linn, S. C., Schröder, C. P., van Asperen, C. J., van Diest, P. J., Zonderland, H. M., van Krieken, J.H.J.M., editor, Beets-Tan, R.G.H., editor, Gelderblom, A.J., editor, Olofsen, M.J.J., editor, and Rutten, H.J.T., editor

Published
2020
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6. Mammatumoren

Author

van de Velde, C. J. H., van Asperen, C. J., van Diest, P. J., Elkhuizen, P. H. M., Linn, S. C., Zonderland, H. M., Liefers, G. J., van de Velde, C.J.H., editor, van der Graaf, W.T.A., editor, van Krieken, J.H.J.M., editor, and Marijnen, C.A.M., editor

Published
2017
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7. A conceptual framework of the values of nutrition health professionals in the Netherlands

Author

Gillies, Christina, Elkhuizen, Samantha, and Wagemakers, Annemarie

Abstract

ABSTRACTNutrition health professionals play important roles in developing and implementing healthy eating strategies for socioeconomically disadvantaged populations. However, the values of nutrition health professionals that inform and underly their everyday decisions and practices are not explicit. The purpose of this study was to identify and synthesize the key values of nutrition health professionals. An explorative qualitative research design was used in which a purposive sample of nutrition health professionals (n = 29) were interviewed. The ‘Values Wheel of Nutrition Health Professionals (VWNHP)’ was created, consisting of 16 values organized into six groups of complementary values – self-transcendence, self-enhancement, openness to change, conservation, connection, and perseverance. The VWNHP may be utilized as a tool to support the critical reflection in health promotion training and practice needed to address nutrition inequities.

Published
2024
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15. OC-0067 De-escalation of radiation therapy after primary chemotherapy in cT1-2N1 breast cancer (RAPCHEM)

Author

de Wild, S., primary, de Munck, L., additional, Verloop, J., additional, van Dalen, T., additional, Elkhuizen, P., additional, Houben, R., additional, van Leeuwen, E., additional, Linn, S., additional, Pijnappel, R., additional, Poortmans, P., additional, Strobbe, L., additional, Wesseling, J., additional, Voogd, A., additional, and Boersma, L., additional

Published
2021
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19. Mammatumoren

Author

van de Velde, C. J. H., primary, Elkhuizen, P. H. M., additional, Nortier, J. W. R., additional, van Diest, P. J., additional, and Zonderland, H. M., additional

Published
2011
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20. Toward omitting sentinel lymph node biopsy after neoadjuvant chemotherapy in patients with clinically node-negative breast cancer

Author

van der Noordaa, M E M, primary, van Duijnhoven, F H, additional, Cuijpers, F N E, additional, van Werkhoven, E, additional, Wiersma, T G, additional, Elkhuizen, P H M, additional, Winter-Warnars, G, additional, Dezentje, V, additional, Sonke, G S, additional, Groen, E J, additional, Stokkel, M, additional, and Vrancken Peeters, M T F D, additional

Published
2020
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23. Study protocols of three parallel phase 1 trials combining radical radiotherapy with the PARP inhibitor olaparib

Author

de Haan, R, van Werkhoven, E, van den Heuvel, M M, Peulen, H M U, Sonke, G S, Elkhuizen, P, van den Brekel, M W M, Tesselaar, M E T, Vens, C, Schellens, J H M, van Triest, B, Verheij, M, Afd Pharmacoepi & Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology, Arbeids- en Organisatie Psychologie (Psychologie, FMG), FMG, MKA AMC (OII, ACTA), Afd Pharmacoepi & Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology, CCA - Cancer Treatment and quality of life, Academic Medical Center, and Maxillofacial Surgery (AMC)

Subjects
0301 basic medicine, Oncology, Cancer Research, Lung Neoplasms, medicine.medical_treatment, Piperazines, Study Protocol, chemistry.chemical_compound, Olaparib, 0302 clinical medicine, TITE-CRM, Surgical oncology, Carcinoma, Non-Small-Cell Lung, Neoplasms, Doselimiting toxicity, Dose limiting toxicity, Common Terminology Criteria for Adverse Events, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Tolerability, Head and Neck Neoplasms, 030220 oncology & carcinogenesis, PARP inhibitor, Carcinoma, Squamous Cell, Rare cancers Radboud Institute for Health Sciences [Radboudumc 9], medicine.medical_specialty, Maximum Tolerated Dose, Antineoplastic Agents, Breast Neoplasms, Phase 1, Poly(ADP-ribose) Polymerase Inhibitors, Rare cancers Radboud Institute for Molecular Life Sciences [Radboudumc 9], lcsh:RC254-282, 03 medical and health sciences, Breast cancer, SDG 3 - Good Health and Well-being, Internal medicine, Genetics, medicine, Humans, Radiotherapy, Dose escalation, business.industry, Radiosensitisation, medicine.disease, Head and neck squamous-cell carcinoma, Radiation therapy, 030104 developmental biology, chemistry, Phthalazines, Radiotherapy, Adjuvant, business
Abstract

BackgroundPoly (ADP-ribose) Polymerase (PARP) inhibitors are promising novel radiosensitisers. Pre-clinical models have demonstrated potent and tumour-specific radiosensitisation by PARP inhibitors. Olaparib is a PARP inhibitor with a favourable safety profile in comparison to clinically used radiosensitisers including cisplatin when used as single agent. However, data on safety, tolerability and efficacy of olaparib in combination with radiotherapy are limited.MethodsOlaparib is dose escalated in combination with radical (chemo-)radiotherapy regimens for non-small cell lung cancer (NSCLC), breast cancer and head and neck squamous cell carcinoma (HNSCC) in three parallel single institution phase 1 trials. All trials investigate a combination treatment of olaparib and radiotherapy, the NSCLC trial also investigates a triple combination of olaparib, radiotherapy and concurrent low dose cisplatin. The primary objective is to identify the maximum tolerated dose of olaparib in these combination treatments, defined as the dose closest to but not exceeding a 15% probability of dose limiting toxicity. Each trial has a separate dose limiting toxicity definition, taking into account incidence, duration and severity of expected toxicities without olaparib. Dose escalation is performed using a time-to-event continual reassessment method (TITE-CRM). TITE-CRM enables the incorporation of late onset toxicity until one year after treatment in the dose limiting toxicity definition while maintaining an acceptable trial duration. Olaparib treatment starts two days before radiotherapy and continues during weekends until two days after radiotherapy. Olaparib will also be given two weeks and one week before radiotherapy in the breast cancer trial and HNSCC trial respectively to allow for translational research. Toxicity is scored using common terminology criteria for adverse events (CTCAE) version 4.03. Blood samples, and tumour biopsies in the breast cancer trial, are collected for pharmacokinetic and pharmacodynamic analyses.DiscussionWe designed three parallel phase 1 trials to assess the safety and tolerability of the PARP inhibitor olaparib in combination with radical (chemo-)radiotherapy treatment regimens. PARP inhibitors have the potential to improve outcomes in patients treated with radical (chemo-)radiotherapy, by achieving higher locoregional control rates and/or less treatment associated toxicity.Trial registrationClinicalTrials.govIdentifiers: NCT01562210 (registered March 23, 2012), NCT02227082 (retrospectively registered August 27, 2014), NCT02229656 (registered September 1, 2014).

Published
2019
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28. Toward omitting sentinel lymph node biopsy after neoadjuvant chemotherapy in patients with clinically node-negative breast cancer.

Author

van der Noordaa, M. E. M., van Duijnhoven, F. H., Cuijpers, F. N. E., van Werkhoven, E., Wiersma, T. G., Elkhuizen, P. H. M., Winter-Warnars, G., Dezentje, V., Sonke, G. S., Groen, E. J., Stokkel, M., and Peeters, M. T. F. D. Vrancken

Subjects
SENTINEL lymph node biopsy, BREAST cancer, NEOADJUVANT chemotherapy, LYMPH node cancer, EPIDERMAL growth factor receptors, HORMONE receptor positive breast cancer, TRIPLE-negative breast cancer
Abstract

Background: The nodal positivity rate after neoadjuvant chemotherapy (ypNþ) in patients with clinically node-negative (cN0) breast cancer is low, especially in those with a pathological complete response of the breast. The aim of this study was to identify characteristics known before surgery that are associated with achieving ypN0 in patients with cN0 disease. These characteristics could be used to select patients in whom sentinel lymph node biopsy may be omitted after neoadjuvant chemotherapy. Methods: This cohort study included patients with cT1-3 cN0 breast cancer treated with neoadjuvant chemotherapy followed by breast surgery and sentinel node biopsy between 2013 and 2018. cN0 was defined by the absence of suspicious nodes on ultrasound imaging and PET/CT, or absence of tumour cells at fine-needle aspiration. Univariable and multivariable logistic regression analyses were performed to determine predictors of ypN0. Results: Overall, 259 of 303 patients (85.5 per cent) achieved ypN0, with high rates among those with a radiological complete response (rCR) on breast MRI (95·5 per cent). Some 82 per cent of patients with hormone receptor-positive disease, 98 per cent of those with triple-negative breast cancer (TNBC) and all patients with human epidermal growth factor receptor 2 (HER2)-positive disease who had a rCR achieved ypN0. Multivariable regression analysis showed that HER2-positive (odds ratio (OR) 5·77, 95 per cent c.i. 1·91 to 23·13) and TNBC subtype (OR 11·65, 2·86 to 106·89) were associated with ypN0 status. In addition, there was a trend toward ypN0 in patients with a breast rCR (OR 2·39, 0·95 to 6·77). Conclusion: The probability of nodal positivity after neoadjuvant chemotherapy was less than 3 per cent in patients with TNBC or HER2-positive disease who achieved a breast rCR on MRI. These patients could be included in trials investigating the omission of sentinel node biopsy after neoadjuvant chemotherapy. [ABSTRACT FROM AUTHOR]

Published
2021
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30. Study protocols of three parallel phase 1 trials combining radical radiotherapy with the PARP inhibitor olaparib

Author

Haan, R. den, Werkhoven, E. van, Heuvel, M. van den, Peulen, H.M.U., Sonke, G.S., Elkhuizen, P., Brekel, M.W. van den, Tesselaar, M.E., Vens, C., Schellens, J.H., Triest, B. van, Verheij, M., Haan, R. den, Werkhoven, E. van, Heuvel, M. van den, Peulen, H.M.U., Sonke, G.S., Elkhuizen, P., Brekel, M.W. van den, Tesselaar, M.E., Vens, C., Schellens, J.H., Triest, B. van, and Verheij, M.

Abstract

Contains fulltext : 208573.pdf (publisher's version ) (Open Access), BACKGROUND: Poly (ADP-ribose) Polymerase (PARP) inhibitors are promising novel radiosensitisers. Pre-clinical models have demonstrated potent and tumour-specific radiosensitisation by PARP inhibitors. Olaparib is a PARP inhibitor with a favourable safety profile in comparison to clinically used radiosensitisers including cisplatin when used as single agent. However, data on safety, tolerability and efficacy of olaparib in combination with radiotherapy are limited. METHODS: Olaparib is dose escalated in combination with radical (chemo-)radiotherapy regimens for non-small cell lung cancer (NSCLC), breast cancer and head and neck squamous cell carcinoma (HNSCC) in three parallel single institution phase 1 trials. All trials investigate a combination treatment of olaparib and radiotherapy, the NSCLC trial also investigates a triple combination of olaparib, radiotherapy and concurrent low dose cisplatin. The primary objective is to identify the maximum tolerated dose of olaparib in these combination treatments, defined as the dose closest to but not exceeding a 15% probability of dose limiting toxicity. Each trial has a separate dose limiting toxicity definition, taking into account incidence, duration and severity of expected toxicities without olaparib. Dose escalation is performed using a time-to-event continual reassessment method (TITE-CRM). TITE-CRM enables the incorporation of late onset toxicity until one year after treatment in the dose limiting toxicity definition while maintaining an acceptable trial duration. Olaparib treatment starts two days before radiotherapy and continues during weekends until two days after radiotherapy. Olaparib will also be given two weeks and one week before radiotherapy in the breast cancer trial and HNSCC trial respectively to allow for translational research. Toxicity is scored using common terminology criteria for adverse events (CTCAE) version 4.03. Blood samples, and tumour biopsies in the breast cancer trial, are collected for

Published
2019

31. Study protocols of three parallel phase 1 trials combining radical radiotherapy with the PARP inhibitor olaparib

Author

Afd Pharmacoepi & Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology, de Haan, R, van Werkhoven, E, van den Heuvel, M M, Peulen, H M U, Sonke, G S, Elkhuizen, P, van den Brekel, M W M, Tesselaar, M E T, Vens, C, Schellens, J H M, van Triest, B, Verheij, M, Afd Pharmacoepi & Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology, de Haan, R, van Werkhoven, E, van den Heuvel, M M, Peulen, H M U, Sonke, G S, Elkhuizen, P, van den Brekel, M W M, Tesselaar, M E T, Vens, C, Schellens, J H M, van Triest, B, and Verheij, M

Published
2019

32. PO-0987: Target volume changes of brain metastases during fractionated SRS

Author

Hessen, E., primary, Damen, P., additional, Jasperse, B., additional, Dewit, L., additional, Elkhuizen, P., additional, Van Mourik, A., additional, Wittkamper, F., additional, Damen, E., additional, Van der Heide, U., additional, Hanssens, P., additional, Schasfoort, J., additional, Nijkamp, J., additional, and Borst, G., additional

Published
2018
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35. Evaluation of delineating the target volume by radiation therapists in breast cancer patients

Author

van Pelt, V.W.J., Gerrets, S., Simões, R., Elkhuizen, P.H.M., and Janssen, T.M.

Abstract

Breast radiotherapy accounts for a significant workload in radiotherapy departments. In 2015 it became clinical practice at the Netherlands Cancer Institute for radiation therapists (RTTs) to delineate the clinical target volume of the breast tissue (CTVbreast) and in 2017 axilla level I-II (CTVln12) according to a delineation atlas. All RTTs were trained and got individual feedback. The aim of this retrospective study was to investigate the variation between the CTVbreast with or without CTVln12 delineated by a trained group of radiation therapists and the clinical adjusted delineations by the radiation oncologist/physician assistant (RO/PA), in a large group of patients treated between January 2017 and June 2020.

Published
2021
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37. Prognostic Factors for Local Control in Breast Cancer After Long-term Follow-up in the EORTC Boost vs No Boost Trial: A Randomized Clinical Trial

Author

Vrieling, C., Werkhoven, E. van, Maingon, P., Poortmans, P., Weltens, C., Fourquet, A., Schinagl, D.A., Oei, B., Rodenhuis, C.C., Horiot, J.C., Struikmans, H., Limbergen, E. van, Kirova, Y., Elkhuizen, P., Bongartz, R., Miralbell, R., Morgan, D.A., Dubois, J.B., Remouchamps, V., Mirimanoff, R.O., Hart, G., Collette, S., Collette, L., Bartelink, H., Vrieling, C., Werkhoven, E. van, Maingon, P., Poortmans, P., Weltens, C., Fourquet, A., Schinagl, D.A., Oei, B., Rodenhuis, C.C., Horiot, J.C., Struikmans, H., Limbergen, E. van, Kirova, Y., Elkhuizen, P., Bongartz, R., Miralbell, R., Morgan, D.A., Dubois, J.B., Remouchamps, V., Mirimanoff, R.O., Hart, G., Collette, S., Collette, L., and Bartelink, H.

Abstract

Item does not contain fulltext, Importance: Prognostic factors of ipsilateral breast tumor recurrence (IBTR) may change over time following breast-conserving therapy. Objective: The EORTC "boost no boost" trial showed that young age and high-grade invasive carcinoma were the most important risk factors for IBTR. This study reanalyses pathological prognostic factors related to IBTR using long-term follow-up. Design, Setting, and Participants: Participants included 5569 early-stage breast cancer patients, treated with breast-conserving surgery (BCS) and whole-breast irradiation (WBI), who were randomized between no boost and a 16-Gy boost in the EORTC phase III "boost no boost" trial (1989-1996). A total of 1616 patients with a microscopically complete resection (according to local pathologists), included in the central pathology review, have been analyzed in this study. Median follow-up was 18.2 years. Interventions: No further treatment or 16-Gy boost, after BCS and 50-Gy WBI. Main Outcomes and Measures: Time to ipsilateral breast tumor recurrence (IBTR) as first event. Results: The 20-year cumulative incidence of IBTR in 1616 patients (160 events observed) was 15% (95% CI, 12%-17%). Young age (P < .001) and presence of ductal carcinoma in situ (DCIS) (HR, 2.15; 95% CI, 1.36-3.38; P = .001) were associated with an increased risk of IBTR in multivariable analysis. The cumulative incidence of IBTR at 20 years was 34% (95% CI, 25%-41%), 14% (95% CI, 10%-18%), and 11% (95% CI, 8%-15%), in patients 40 years or younger, 41 to 50 years and 50 years or older, respectively (P < .001). This incidence was 18% (95% CI, 14%-22%) and 9% (95% CI, 6%-12%) for tumors with and without DCIS (P < .001). High-grade tumors relapsed more frequently early during follow-up but the relative effect of age and presence of DCIS seemed stable over time. The boost reduced the 20-year IBTR incidence from 31% (95% CI, 22%-39%) to 15% (95% CI, 8%-21%) (HR, 0.37; 95% CI, 0.22-0.62; P < .001) in high-risk patients (

Published
2017

40. Whole-breast irradiation with or without a boost for patients treated with breast-conserving surgery for early breast cancer: 20-year follow-up of a randomised phase 3 trial

Author

Bartelink, H., Maingon, P., Poortmans, P.M.P., Weltens, C., Fourquet, A., Jager, J., Schinagl, D.A., Oei, B., Rodenhuis, C., Horiot, J.C., Struikmans, H., Limbergen, E. van, Kirova, Y., Elkhuizen, P., Bongartz, R., Miralbell, R., Morgan, D., Dubois, J.B., Remouchamps, V., Mirimanoff, R.O., Collette, S., Collette, L., Bartelink, H., Maingon, P., Poortmans, P.M.P., Weltens, C., Fourquet, A., Jager, J., Schinagl, D.A., Oei, B., Rodenhuis, C., Horiot, J.C., Struikmans, H., Limbergen, E. van, Kirova, Y., Elkhuizen, P., Bongartz, R., Miralbell, R., Morgan, D., Dubois, J.B., Remouchamps, V., Mirimanoff, R.O., Collette, S., and Collette, L.

Abstract

Item does not contain fulltext, BACKGROUND: Since the introduction of breast-conserving treatment, various radiation doses after lumpectomy have been used. In a phase 3 randomised controlled trial, we investigated the effect of a radiation boost of 16 Gy on overall survival, local control, and fibrosis for patients with stage I and II breast cancer who underwent breast-conserving treatment compared with patients who received no boost. Here, we present the 20-year follow-up results. METHODS: Patients with microscopically complete excision for invasive disease followed by whole-breast irradiation of 50 Gy in 5 weeks were centrally randomised (1:1) with a minimisation algorithm to receive 16 Gy boost or no boost, with minimisation for age, menopausal status, presence of extensive ductal carcinoma in situ, clinical tumour size, nodal status, and institution. Neither patients nor investigators were masked to treatment allocation. The primary endpoint was overall survival in the intention-to-treat population. The trial is registered with ClinicalTrials.gov, number NCT02295033. FINDINGS: Between May 24, 1989, and June 25, 1996, 2657 patients were randomly assigned to receive no radiation boost and 2661 patients randomly assigned to receive a radiation boost. Median follow-up was 17.2 years (IQR 13.0-19.0). 20-year overall survival was 59.7% (99% CI 56.3-63.0) in the boost group versus 61.1% (57.6-64.3) in the no boost group, hazard ratio (HR) 1.05 (99% CI 0.92-1.19, p=0.323). Ipsilateral breast tumour recurrence was the first treatment failure for 354 patients (13%) in the no boost group versus 237 patients (9%) in the boost group, HR 0.65 (99% CI 0.52-0.81, p<0.0001). The 20-year cumulative incidence of ipsilatelal breast tumour recurrence was 16.4% (99% CI 14.1-18.8) in the no boost group versus 12.0% (9.8-14.4) in the boost group. Mastectomies as first salvage treatment for ipsilateral breast tumour recurrence occurred in 279 (79%) of 354 patients in the no boost group versus 178 (75%) of 237 in the b

Published
2015

41. Erratum to : Gene expression profiling to predict the risk of locoregional recurrence in breast cancer: A pooled analysis [Breast Cancer Res Treat, (2014), 148, (599-613), 10.1007/s10549-014-3188-z]

Author

Drukker, C. A., Elias, S. G., Nijenhuis, M. V., Wesseling, J., Bartelink, H., Elkhuizen, P., Fowble, B., Whitworth, P. W., Patel, R. R., de Snoo, F. A., van’t Veer, L. J., Beitsch, P. D., Rutgers, E. J Th, Drukker, C. A., Elias, S. G., Nijenhuis, M. V., Wesseling, J., Bartelink, H., Elkhuizen, P., Fowble, B., Whitworth, P. W., Patel, R. R., de Snoo, F. A., van’t Veer, L. J., Beitsch, P. D., and Rutgers, E. J Th

Published
2015

42. Erratum to: Gene expression profiling to predict the risk of locoregional recurrence in breast cancer: A pooled analysis [Breast Cancer Res Treat, (2014), 148, (599-613), 10.1007/s10549-014-3188-z]

Author

Epi Kanker Team A, Cancer, JC onderzoeksprogramma Kanker, Pathologie patiënten zorg, Infection & Immunity, MS Reumatologie/Immunologie/Infectie, Drukker, C. A., Elias, S. G., Nijenhuis, M. V., Wesseling, J., Bartelink, H., Elkhuizen, P., Fowble, B., Whitworth, P. W., Patel, R. R., de Snoo, F. A., van’t Veer, L. J., Beitsch, P. D., Rutgers, E. J Th, Epi Kanker Team A, Cancer, JC onderzoeksprogramma Kanker, Pathologie patiënten zorg, Infection & Immunity, MS Reumatologie/Immunologie/Infectie, Drukker, C. A., Elias, S. G., Nijenhuis, M. V., Wesseling, J., Bartelink, H., Elkhuizen, P., Fowble, B., Whitworth, P. W., Patel, R. R., de Snoo, F. A., van’t Veer, L. J., Beitsch, P. D., and Rutgers, E. J Th

Published
2015

43. Richtlijn 'Behandeling van het mammacarcinoom 2008' (herziening)

Author

Struikmans, H., Nortier, J. W. R., Rutgers, E. J. Th, Zonderland, H. M., Bontenbal, M., Elkhuizen, P. H. M., van Tienhoven, G., Tjan-Heijnen, V. C. G., van Vegchel, T., Tuut, M. K., Benraadt, J., Radiology and Nuclear Medicine, Cancer Center Amsterdam, and Radiotherapy

Abstract

The Dutch evidence-based guideline 'Treatment of breast cancer' has been revised, and integrated with the guideline 'Screening for and diagnosis of breast cancer'. The guideline can be found on www. oncoline.nl and on www.cbo.nl. The Internet programme 'Adjuvant!' (www.adjuvantonline.com) can be used to predict both the prognosis and the efficacy of systemic adjuvant therapy for each patient. The indications for adjuvant chemotherapy and endocrine therapy have been widened. The aim is to reduce the absolute probability of death by at least 4-5% within 10 years. The goal of neoadjuvant chemotherapy in operable breast cancer is to enable breast-conserving therapy for large tumours in relatively small breasts. One could consider transferring responsibility for follow-up after 5 years from the hospital to the screening organisation following mastectomy, to the family doctor following breast-conserving therapy, and to an outpatient clinic for hereditary tumours in carriers of gene mutation. Cessation of follow-up above the age of 75 could also be considered

Published
2008

44. PET/CT with 18F-FDG predicts short-term outcome in stage II/III breast cancer patients upstaged to N2/3 nodal disease.

Author

Teixeira, S.C., Koolen, B.B., Elkhuizen, P.H.M., Vrancken Peeters, M.-J.T.F.D., Stokkel, M.P.M., Rodenhuis, S., van der Noort, V., Rutgers, E.J.T., and Valdés Olmos, R.A.

Subjects
BREAST cancer patients, BREAST cancer treatment, HEALTH outcome assessment
Abstract

Introduction 18 F-FDG PET/CT has high positive predictive value for the detection of avid lymph node metastases in breast cancer patients. We analysed the effect of upstaging lymph nodes by PET/CT on short-term outcome in stage II/III breast cancer patients. Patients and methods A total of 278 stage II/III primary breast cancer patients (mean age 48.9 years, range 19–75 years) were re-staged with 18 F-FDG PET/CT before start of pre-operative systemic treatment (PST). Patients were divided in three groups based on risk for local recurrence: a low – (T2N0), intermediate – (T0-2N1 and T3N0) and a high-risk group (T0-3N2–3, T3N1 and T4). Within these groups we looked at local recurrence-free survival (LRFS), recurrence-free survival (RFS) and overall survival (OS) within the first 3 years of follow-up. Results With a median follow-up (FU) of 50 months the RFS, LRFS and OS were 87%, 88% and 92% respectively for the whole group. PET/CT upstaged 43 patients from the low- and intermediate risk group to the high-risk group, based on detection of ≥4 avid axillary nodes or occult N2/3-disease. Patients upstaged with PET/CT had more events for all three analyses compared to the original risk groups, which resulted in a significantly worse RFS (69.8%; p = 0.03) a nearly significantly worse LRFS (p = 0.052) and no effect in OS (p = 0.433). Discussion Additional PET/CT staging allows breast cancer patients to be treated according to the true stage, still stage II/III breast cancer patients upstaged to N2/3 by PET/CT have worse short-term outcome, despite adjustment of treatment, than patients staged high-risk with conventional imaging. [ABSTRACT FROM AUTHOR]

Published
2017
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45. Histological determinants for different types of local recurrence after breast-conserving therapy of invasive breast cancer. Dutch Study Group on local Recurrence after Breast Conservation (BORST)

Author

Voogd, A. C., Peterse, J. L., Crommelin, M. A., Rutgers, E. J., Botke, G., Elkhuizen, P. H., van Geel, A. N., Hoekstra, C. J., van Pel, R., van de Vijver, M. J., Coebergh, J. W., and Other departments

Abstract

The purpose of this study was to determine which histological factors are associated with an increased risk for local recurrence in the breast after breast-conserving therapy for early breast cancer (TNM stage I and II) and whether risk patterns vary according to menopausal status and type of local recurrence. Through complete follow-up of the patients of eight regional radiation oncology departments, two cancer institutes and one surgical clinic in The Netherlands, 360 patients were identified with local recurrence in the breast after having received breast-conserving therapy (local tumour excision, axillary dissection and irradiation of the whole breast and a boost to the tumour bed) during the 1980s. For each case, two controls with a follow-up of similar duration without local recurrence were randomly selected. Histological slides of the primary tumour were reviewed. Among premenopausal patients the risk of recurrence for those younger than 35 years was significantly higher than that for premenopausal patients of 45 years or older (relative risk (RR) 2.9; 95% confidence interval (95% CI) 1.3-6.6, P

Published
1999

48. Low risk of recurrence in elderly patients treated with breast conserving therapy in a single institute.

Author

van der Leij, Femke, van Werkhoven, Erik, Bosma, Sophie, Linn, Sabine C., Rutgers, Emiel J., van de Vijver, Marc J., Bartelink, Harry, Elkhuizen, Paula H.M., and Scholten, Astrid

Subjects
BREAST cancer patients, CANCER relapse, CANCER radiotherapy, BREAST surgery, DECISION making, DISEASES in older people
Abstract

Objectives To guide decision making in preventing over- or under-treatment in older breast cancer patients who have undergone breast conserving surgery, we analyzed prognostic factors and risk of recurrence in a consecutive series of patients ≥ 65 years old with breast cancer and identified subgroups that may benefit or not from more intensive treatment. Methods Patients ≥65 years of age with breast cancer (pT1-2/pN0-2) treated with breast conserving surgery and postoperative radiation therapy at the Netherlands Cancer Institute (NKI) between 1980 and 2008 were identified. Endpoints were locoregional recurrence (LRR), distant metastasis (DM) and overall survival (OS). Multivariable analyses were performed using Cox proportional hazards models. Results 1922 patients with a median age of 70 years were analyzed. The 5- and 10- years LRR rates were 2% and 3% respectively. In multivariable analysis there was no significant factor influencing LRR risk. Patients with low risk tumors (node negative patients with T1 and ER positive, grade 1 or 2) had lower risk of DM (HR 0.26) and better OS (HR 0.65) compared to patients with higher risk tumors (grade 3 and/or node positive). Conclusion In elderly breast cancer patients the risk of LRR and DM is low. In patients with less favorable characteristics the risk of LRR is equally low, with a higher risk to develop DM and worse OS. Treatment in the low risk group may be minimized, while for the higher risk group adjuvant treatment could be intensified. [ABSTRACT FROM AUTHOR]

Published
2016
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