Radiation oncology; Breast cancer, Online adaptive radiotherapy, MR-guided radiotherapy, hyperthermia.
Focus of research
Dr. van den Bongards research is focussed on the optimization of breast cancer radiotherapy to reduce toxicity in breast cancer patients, such as breast fibrosis and cardiotoxicity, and to optimize quality of life while preserving treatment efficacy.
One of the research lines is the introduction of MR-guided radiotherapy in breast cancer to reduce the irradiated volumes compared with standard CT-guided radiotherapy. In the ABLATIVE trial (NL 46017.041.13, KWF/Pink Ribbon grant), the clinical feasibility of single ablative dose MR-guided pre-operative partial breast irradiation (PBI) instead of standard post-operative irradiation during one to four weeks was investigated in low-risk patients. A pathologic complete response was observed in 42% of the accrued patients, six to eight months after single-dose pre-operative PBI. In the multicenter ABLATIVE-2 trial (KWF grant, NL77000.029.21), the pathologic response at one year after MR-guided single-dose pre-operative PBI will be evaluated in low-risk breast cancer patients. Besides the evaluation of radiologic response on MRI, biomarkers in blood and tumor tissue will be evaluated after single-dose PBI aiming to predict pathologic response in future patients. Patients will be treated in the prone or supine position that is most favorable for the surrounding organs at risk (e.g. heart, lung, contralateral breast).
Recently, the national RT-HYPE project with focus on the optimization of treatment in patients with breast cancer recurrence in the ipsilateral breast and/or regional lymph nodes has been granted by KWF. In this multicenter prospective cohort study locoregional control, survival, toxicity and quality of life will be evaluated in high-risk IBTR patients after standard treatment (i.e. surgery, post-operative re-irradation with or without hyperthermia) allowing the collection of real-world data and optimization of the shared decision making process in patients with recurrent breast cancer.
Online adaptive radiotherapy instead of the standard offline adaptive radiotherapy in breast cancer patients is currently being implemented (BREAST-ART, VARIAN grant). Online adaptive radiotherapy in breast cancer patients allows adaptation of the radiotherapy plan on the same day (instead of offline adaptation that takes on average two days as is currently standard of care).
Dr van den Bongard is also involved in several national projects, such as the assessment of coronary calcifications using Artificial Intelligence (BRAGATSTON project, KWF), development of decision aids (BRASA trial, Alpe d’Huzes), influence of COVID-19 on breast cancer treatment (COVID-19 NABON CONSORTIUM, ZONMW), and international projects including the ARTILLERY project (HORIZON-Europe) on AI algorithms for automated early detection of chronic disease on the radiotherapy planning CT images aiming to decrease toxicity and improve quality of life in breast cancer patients.