In May 2007, Professor Marcel Verheij is appointed as head of the Department of Radiotherapy in the Netherlands Cancer Institute (NKI). Besides this, he is team leader in the department of Cellular Biochemistry and coordinator of the clinical unit for combined modality treatment in the NKI. Since 2004, he is also professor in Translational Radiotherapy at the Free University in Amsterdam.
As successor of Harry Bartelink, Marcel Verheij is faced with the challenge to maintain the achieved high level of research and patient care and to make it grow with future developments and further increase in scale. The radiotherapy department already treats more than 4000 new patients per year. One expects that the treatment capacity is sufficiently large to handle the increasing number of patients for further number of years. The clinic disposes of eight modern linear accelerators, of which four are equipped with CBCT imaging. Furthermore, an exchange machine is available as a back-up for maintenance and physics checks and a treatment room is reserved for future expansion.
A further increase in the quality of care is achieved with recent investments. Intensity modulated radiotherapy (IMRT) and cone beam CT (CBCT)-based image guided radiotherapy (IGRT) enlarge the possibilities of sparing healthy tissue and safely increasing the radiation dose, whether combined with chemotherapy or not. With the irradiation technique based on 4-D CT-scans (mid respiration position CT-scan) a considerable decrease of the dose in the heart is achieved, which reduces the probability of late radiation damage.
CBCT scanning on the linear accelerator enables precise location of the tumour prior to every irradiation. Now a stereotactic irradiation technique has become available which no longer requires immobilizing the patient in an uncomfortable fixation. The treatment of early-stage lung cancer has become more patient friendly. IMRT improves the sparing of healthy tissue in the radiation treatment of cancers of the rectum, anus and cervix uteri, and can reduce the toxicity in the combined treatment with chemotherapy.
An indispensable aid with these precise irradiation techniques is the check of the delivered dose during treatment. This is achieved with the in-vivo dosimetry procedure which is developed in the NKI as application of the EPID system for portal imaging. Because of the increased complexity of the applied irradiation techniques, high priority is given to checking the dose by means of EPID dosimetry. At the end of 2007 all irradiations with curative intent are checked with EPID dosimetry. The next step will be 3-D dose reconstruction based on EPID images taken with a rotating beam.