Radiation therapist Sven van den Bosch of Radboudumc receives a subsidy of 1.3 million euros from the National Health Care Institute. In this study, the so-called sentinel lymph node procedure is used in patients with cancer in the pharynx or larynx. This examination accurately shows whether the disease has spread to lymph nodes in the neck. If this turns out not to be the case, then irradiation of the neck is not necessary, while this is now standard for all patients. This reduces side effects and significantly improves quality of life after healing. This is reported by the Radboudumc.
In one third of patients with cancer of the pharynx or larynx there are metastases in the lymph nodes of the neck, which cannot be detected with standard diagnostic scans. The treatment of these patients often consists of radiation, in which the neck is also irradiated as a precaution because of the risk of metastases. But that causes permanent complaints, such as a dry mouth and difficulty swallowing. These complaints are at the expense of quality of life after cancer has been cured.
FIRST he studies
Radiation therapist Sven van den Bosch of Radboudumc now receives 1.3 million euros from the National Health Care Institute for improving this care. “With the head and neck chain of Radboudumc and in collaboration with a large number of Dutch centers with expertise in head and neck oncology, we will investigate in the PRIMO study whether we can personalize irradiation of the neck based on the sentinel node procedure,” says Van den Bosch. “The sentinel node is the lymph node that is the first to receive the lymph fluid from the tumor. Because tumor cells can spread through the lymph fluid, when they metastasize, they are the first to reach the sentinel node. In this procedure, we therefore inject a radioactive marker around the tumor. “That goes to the nearest lymph nodes. We use a scan to detect these sentinel nodes, after which they are surgically removed. A pathologist uses a microscope to check whether the removed lymph node contains tumor cells.”
If the sentinel nodes do not contain metastases, the other lymph nodes in the neck are no longer irradiated as a precaution. Only the tumor itself is then irradiated. This approach is expected to prevent irradiation of the neck in seven out of ten patients, reducing the area to be irradiated by about eighty percent. Van den Bosch: “With this personalization of the irradiation of the neck, we can prevent permanent complaints in most patients, which means that the quality of life after the cancer has been cured is considerably better.”
By: National Care Guide