prof. Liv Veldeman (MD, PhD)
Clinical Head at the Dept. of Radiation Oncology (UZ Gent)
Clinical Postdoctoral Mandate of Foundation against Cancer (Stichting tegen Kanker)
Assistant Professor (UGent, Dept. of Human Structure and Repair)
Vice-president of BeSTRO (Belgian Society for Radiotherapy and Oncology)
Board Member of the Belgian Radiation Oncology Awareness and Vissibility Organization (BRAVO)
The goal of the breast research team at the Dept. of Radiotherapy is improving the cost-benefit ratio of radiotherapy in breast cancer patients. Since 2008 our most important achievement was the implementation of prone whole-breast irradiation at UZ Gent. Prone, compared to supine, breast radiotherapy results in less acute toxicity, less risk of radiation-induced cardiac toxicity and of lung cancer induction. Drawbacks of prone position are the complicated setup procedure, patient discomfort and reduced precision. When lymph node irradiation is required, prone position is especially challenging. We have designed an innovative prone positioning device with the arm at the treated side alongside the body (crawl position) that provides more comfort and precision than the standard prone device. We are further testing the prone crawl device in the setting of whole-breast with lymph node irradiation. We expect the same benefits regarding acute and late toxicity as in the breast-only group.
Previous research of our group has shown that a technique of deep inspiration breath hold can be used to reduce radiation dose to the heart in prone breast radiotherapy. When using this technique, patients are asked to take a deep breath and hold their breath for a short time during radiation treatment. By inhaling, the heart shifts to an anatomically more favorable position, away from the breast, thus reducing heart dose. We currently use between 3 and 6 breath holds of 12 to 18 seconds for breast-only irradiation. When the lymph nodes are included in the target volumes, the treatment is more complex and requires between 10 and 14 breath holds of 15-30 seconds. This represents a substantial physical and mental effort for all but the most able patients. Therefore, our team is also focusing on finding a technique to assist patients to maintain a long breath hold of around 2.5 minutes during radiotherapy by using oxygen in combination with hyperventilation.
Another research interest of the team is accelerated radiotherapy: fewer sessions of radiation in a shorter time span with a higher dose per fraction. Accelerated radiotherapy is attractive both for the patient (less treatment sessions) and for the hospital (more treatment capacity and shorter waiting lists), but also has some radiobiological advantages (less toxicity and improved tumor control). We are testing an accelerated schedule in 5 fractions in all settings of breast radiotherapy (breast conserving surgery or mastectomy, with or without lymph node irradiation).
- prof. Wilfried De Neve (MD, PhD) - head of research
- prof. Liv Veldeman (MD, PhD) - principal investigator
- dr. Chris Monten (MD, PhD) - postdoctoral fellow
- dr. Pieter Deseyne (MD) - doctoral fellow
- Max Schoepen - doctoral fellow
- Michael Stouthandel - doctoral fellow
- dr. Vincent Vakaet (MD) - doctoral fellow
- Hans Van Hulle - doctoral fellow
- Giselle Post - study coordinator
- Annick van Greveling - study nurse
- Bruno Speleers - dosimetrist
- Prof. Werner De Gersem - physicist
- Luiza Olteanu – physicist
- Leen Paelinck – physicist
- Tom Vercauteren – physicist
- Van Hulle H, Naudts D, Deschepper E, Vakaet V, Paelinck L, Post G, Van Greveling A, Speleers B, Deseyne P, Lievens Y, De Neve W, Veldeman L, Monten C. Accelerating adjuvant breast irradiation in women over 65 years: Matched case analysis comparing a 5-fractions schedule with 15 fractions in early and locally advanced breast cancer. J Geriatric Oncol. 2019. Epub ahead of print.
- Speleers B, Belosi, F, De Gersem W, Deseyne P, Paelinck L, Bolsi A, Lomax A, Boute B, Van Greveling A, Monten C, Van de Velde J, Vercauteren T, Veldeman L, Weber D, De Neve W. Comparison of supine or prone crawl photon or proton breast and regional lymph node radiation therapy including the internal mammary chain. Scientific Reports. 2019;9:4755.
- Mbah C, De Ruyck K, De Schrijver S, De Sutter C, Schiettecatte K, Monten C, Paelinkc L, De Neve W, Thierens H, West C, Amorim G, Thas O, Veldeman L. A new approach for modeling patient overall radiosensitivity and predicting multiple endpoints for breast cancer patients. Acta Oncologica 2018; 57(5):604-612.
- Boute B, De Neve W, Speleers B, Van Greveling A, Monten C, Van Hoof T, Van de Velde J, Paelinck L, De Gersem W, Vercauteren T, Veldeman L. Potential benefits of crawl position for prone radiation therapy in breast cancer. J Appl Clin Med Phys. 2017;18(4):200-205.
- Deseyne P, Speleers B, De Neve W, Boute B, Paelinck L, Van Hoof T, Van de Velde J, Depypere H, Veldeman L. Whole breast and regional nodal irradiation in prone versus supine position in left sided breast cancer. Radiation Oncology. 2017;12:89.
- Monten C, Lievens Y, Olteanu AML, Paelinck L, Speleers B, Deseyne P, Van Den Broecke R, De Neve W, Veldeman L. Highly Accelerated Irradiation in 5 fractions (HAI-5): feasibility in elderly women with early or locally-advanced breast cancer. Int J Radiat Oncol Biol Phys, 2017;98(4):922-930.
- Paelinck L, Gulyban A, Lakosi F, Vercauteren T, De Gersem W, Speleers B, Monten C, Mulliez T, Berkovic P, van Greveling A, Decoster F, Coucke P, De Neve W, Veldeman L. Does an integrated boost increase acute toxicity in prone hypofractionated breast irradiation? A randomized controlled trial. Radiother Oncol. 2017;122:30-6
- Veldeman L, Schiettecatte K, De Sutter C, Monten C, van Greveling A, Berkovic P, Mulliez T, De Neve W. 2-year cosmetic outcome of a randomized trial comparing prone and supine whole-breast irradiation in large-breasted women. Int J Radiat Oncol Biol Phys. 2016 Jul 15;95(4):1210-7.
- Mulliez T, Veldeman L, Speleers B, Mahjoubi K, Remouchamps V, Van Greveling A, Gilsoul M, Berwouts D, Lievens Y, Van den Broecke R, De Neve W. Heart dose reduction by prone deep inspiration breath hold in left-sided breast irradiation. Radiother Oncol. 2015 Jan;114(1):79-84.
- Veldeman L, De Gersem W, Speleers B, Truyens B, Van Greveling A, Van den Broecke R, De Neve W. Alternated prone and supine whole-breast irradiation using IMRT: setup precision, respiratory movement and treatment time. Int J Radiat Oncol Biol Phys 2012;82(5):2055-64.
- Veldeman L, Madani I, Hulstaert F, De Meerleer G, Mareel M, De Neve W. Evidence behind use of intensity-modulated radiotherapy: a systematic review of comparative clinical studies. Lancet Oncology 2008;9:367-75.
Contact & links
- Ghent University Hospital, Dept. of Radiation Oncology, 0 RTP – entrance 98, Corneel Heymanslaan 10, B-9000 Gent
- 'Stichting tegen Kanker' webinar 24/11/2020: 'Professor Liv Veldeman: Een nieuwe aanpak van radiotherapie bij borstkanker.' - watch the recording (in Dutch)
- 'Kom op tegen Kanker' educational video on an improved position to irradiate breast cancer patients - watch the video (in Dutch)