Articles

Individualising radiation therapy decisions in breast cancer patients based on tumour-infiltrating lymphocytes and genomic biomarkers

BJMO - volume 17, issue 6, october 2023

M. Machiels MD, PhD, R. Oulkadi MD, T. Tramm MD, PhD, S.R. Stecklein MD, PhD, N. Somaiah MD, PhD, A. De Caluwé MD, J. Klein MD, PhD, W.T. Tran MD, PhD, R. Salgado MD, PhD

SUMMARY

Radiation therapy (RT) has long been fundamental for the curative treatment of breast cancer. While substantial progress has been made in the anatomical and technological precision of RT delivery, and some approaches to de-escalate or omit RT based on clinic-pathologic features have been successful, there remain substantial opportunities to refine individualised RT based on tumour biology. A major area of clinical and research interest is to ascertain the individualised risk of loco-regional recurrence to direct treatment decisions regarding escalation and de-escalation of RT. Patient-tailored treatment with RT is considerably lagging behind compared with the massive progress made in the field of personalised medicine that currently mainly applies to decisions on the use of systemic therapy or targeted agents.

Herein we review select literature surrounding the use of tumour genomic biomarkers and biomarkers of the immune system, including tumour-infiltrating lymphocytes (TILs), within the management of breast cancer, specifically as they relate to progress in moving toward analytically validated and clinically tested biomarkers utilised in RT.

(Belg J Med Oncol 2023;17(6):216–29)

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Optimising target volume definition and treatment accuracy in oesophageal cancer

BJMO - volume 15, issue 2, march 2021

M. Machiels MD, PhD

SUMMARY

On May 29th, 2020, M. Machiels defended her PhD thesis entitled ‘Optimising target volume definition and treatment accuracy in oesophageal cancer‘. The research was carried out at the Amsterdam UMC, location AMC under supervision of promotor prof. C.R.N. Rasch, MD, PhD, with dr. M.C.C.M. Hulshof, MD, PhD and Mrs. T. Alderliesten, PhD as co-promoters. Important findings are listed below. Full thesis is available at: http://hdl.handle.net/11245.1/2e692172-00cf-4565-b45c-04d1dffb951a.

(BELG J MED ONCOL 2021;15(2):83-6)

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Partial breast irradiation of early-stage breast cancer

BJMO - volume 14, issue 4, june 2020

M. Machiels MD, PhD, D. Nevens MD, PhD, K. Erven MD, PhD, G. Buelens MD, C. Billiet MD, PhD, Y. Geussens MD, P. Janssens MD, S. Vanderkam MD, R. Weytjens MD

SUMMARY

Whole-breast irradiation, as part of breast-conservation therapy (BCT), has been well-established the last decades. Nonetheless, most local recurrences found after BCT are within or close to the tumour bed. This led to the concept of partial breast irradiation (PBI), delivering the radiation dose to a decreased target volume, thereby lowering exposure to the organs at risk and hence potentially minimizing late adverse effects. This became increasingly important with growing survivorship of patients with early-stage breast cancer over the past decades and the consideration of late adverse effects is gaining more importance. In this review, we will present an overview of the current literature, techniques to deliver PBI and we try to establish whether there is a place for PBI in early-stage breast cancer treatment.

(BELG J MED ONCOL 2020;14(4):140–45)

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