Less irradiation for 9 out of 10 patients with laryngeal and pharyngeal cancer KWF investing 13.9 million euros for a better life with and after cancer

Caring for cancer patients after major surgery. A chemopump to prevent bile duct cancer from returning after surgery. Neck gland radiation safely omitted for throat and larynx cancer. Making microbubbles dance to sound to vibrate open blood vessels so treatments work better. KWF is investing 13.9 million euros in these and other studies that contribute to a better life with and after cancer. All 19 studies will start this year. One of the recepients of the KWF grant is Sven van den Bosch from Radboudumc, who aims to reduce irradiation in patients with laryngeal and pharyngeal cancer.

In radiotherapy for laryngeal and pharyngeal cancer, both the primary tumor and the lymph nodes at both sides of the neck are included in the radiation target volume. The lymph nodes are also irradiated when no nodal metastases were detected during diagnostic work-up. The aim is to eradicate lymph node metastases that stay under the diagnostic detection level.

However, most toxicity and permanent long-term radiation side effects are caused by irradiation of the lymph nodes because the irradiated tissue volume is much larger than what is necessary to treat only the primary tumor. These side effects, and in particular dysphagia and xerostomia, are notoriously known to negatively and permanently affect quality of life after treatment.

Radiation oncologist Sven van den Bosch of the Radboudumc we will compare the safety and efficacy of personalized neck node irradiation guided by the results of sentinel lymph node biopsy versus standard neck node irradiation in the multicenter randomized controlled trial. In the PRIMO study, neck node irradiation is omitted when the sentinel lymph node is free of metastases. As a result, an estimated 2 in 10 patients will only need single-sided neck node irradiation and 7 in 10 will need none at all. The irradiated volume will be much smaller in these patients and permanent long-term radiation side effects can be reduced substantially with better quality of life after treatment.

About the KWF 2023-1 round

The studies awarded are the result of the first funding round of 2023. A committee of (inter)national experts and (former) patients assessed 70 research proposals submitted for scientific quality, feasibility and relevance. Based on their expert judgment, KWF decided to fund 19 of them, including 4 from the proceeds of Alpe d'HuZes.