Head & Neck Oncology

Fluorescence guided surgery in head and neck oncology

- Julia Odenthal (PHD student)
- Robert Takes and Peter Friedl (Cell Biology)(supervisors)
- In cooperation with Guido van den Broek, Dirk Kunst; Thijs Merkx (Maxillofacial Surgery); Otto Boerman and Wim Oyen, Mark Rijpkema (Nuclear Medicine); Hein Gooszen, Maroeska Rovers (Operation Rooms/Evidence Based Surgery); Hans Kaanders (Radiation Oncology); Kees van Laarhoven and Hans de Wilt (Surgery); Iris Nagtegaal and Piet Slootweg (Pathology); Ronald Bartels (Neurosurgery); Ruud Bekkers (Gynaecology)
The choice of optimal treatment in head and neck oncology is not only determined by oncological but also by the expected functional outcome. The upper aerodigestive tract is a functionally important anatomical area and impairment of critical structures has severe impact on quality of life. Aspects like airway, speech, voice, swallowing, hearing, smell and appearance are important in this respect. Moreover, the vicinity of important and critical structures may be a limiting factor to create wide surgical margins. Visualisation of tumor cells during surgery after fluorescent labeling of these cells could guide surgery and would be a valuable additional tool to obtain free resection margins without unnecessary sacrifice of vital tissues. It could contribute to improvement of both oncological and functional outcomes.

Optical techniques in the management of premalignant and malignant and pharyngeal lesions

- Henrieke Schutte (ENT resident)
- Guido van den Broek and Robert Takes (supervisors)
- In collaboration with Hans Kaanders (Radiation Oncology); Maroeska Rovers (Operation Rooms/Evidence Based Surgery); Pentax Europe
Treatment of early glottic cancer is by radiotherapy or laser microsurgery in general anaesthesia. The choice of treatment is guided by extension of the lesions and the expected oncological and functional outcome. This project aims at improvement of treatment strategies and follow-up of these lesions by the use of high definition flexible endoscopic techniques. 

Molecular techniques in the management of premalignant and early malignant laryngeal lesions

- Stijn Fleskens (ENT resident)
- Robert Takes, Jeroen van der Laak and Piet Slootweg (Pathology)(supervisors)
- In collaboration with Ernst-Jan Speel and Bernd Kremer (UMC Maastricht) and Michiel van den Brekel and Loes van Velthuizen (AvL/NKI Amsterdam)
The optimal management of premalignant lesions of the larynx is unclear due to the lack of information on the chance on malignant transformation of these lesions. This project aims to investigate how to more accurately predict the risk of malignant transformation in laryngeal premalignant lesions and how the otorhinolaryngologist manages or should manage these lesions in clinical practice.

Gene expression profiling for assessment of radiosensitivity in laryngeal cancer

A collaboration between Robert Takes, Roland Kuiper and Ad Geurts van Kessel (Genetics); Hans Kaanders and Paul Span (Radiation Oncology); Piet Slootweg (Pathology)
Laryngeal cancer is predominantly treated by (chemo-)radiotherapy. The aim of the project is to identify genetic expression profiles in laryngeal tumors to distinguish those that are eliminated by radiotherapy from those that not respond or recur. In selected tumors with a high chance on poor response on radiotherapy alternative treatments may be considered. The molecular information obtained by this research may also give insight in the processes involved in radiosensitivity or -resistence of tumors.

Project management of the no neck in early stage oral cancer; a modeling approach

Tim Govers (PhD student)
Robert Takes, Thijs Merkx (Maxillofacial Surgery); Maroeska Rovers (Operation Rooms/Evidence Based Surgery) (supervisors)

- In collaboration with centres of the Dutch Head and Neck Society (NWHHT)
The inability of current diagnostic tools to detect small lymph node metastasis in patients with oral cancer leads to a rate of undetected metastasis that is too high to refrain from elective neck treatment, resulting in overtreatment. The aim of this project is to identify parameters and techniques that aid the identification of patients with a low risk on nodal metastasis obviating the need for elective neck treatment. Implementation of these techniques in clinical practice facilitates more personalized treatment.