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Corrie Marijnen

‘To really get things moving…’

Bio

Bio

Corrie Marijnen started her training as Radation Oncologist at LUMC in 1994 and received her registration in 1999. In 2002, she completed her thesis on Rectal Cancer and became a member of staff. From 2004 to 2008, she worked at the Department of Radiotherapy in the Netherlands Cancer Institute. She returned
to Leiden as Chair of the Department of Radiotherapy and has been involved in the HollandPTC initiative, for the past few years as Medical Director together with Jean-Philippe Pignol.

POSITION AT:

LUMC: Radiotherapy
TU Delft: Bioinformatics

Building a bridge

“Medical professionals, are always working on improving healthcare for their patients. Innovation with a focus on the individual patient is very important to realize this. For me, collaborating with TU Delft poses a unique opportunity to integrate healthcare needs with technical innovation. Starting by looking around the EEMCS faculty: Electrical Engineering, Mathematics and Computer Science. I see it as my role to build a bridge between what Leiden needs and what TU Delft has to offer.”

“My specialist field is radiotherapy: using radiation to treat cancer. This treatment tends to cause side effects to our patients. In recent years, I have taken an interest in proton therapy, a major step forward  in the treatment of patients with certain types of cancer. It enables a significant reduction of side effects, whilst tumour control is the same as with conventional radiation. As a consequence, the quality of life will be better in cancer survivors.

Within the Medical Delta consortium currently one of the most modern facilities for proton therapy is being built in Delft, facilitating both optimal patient care and innovative research.”

Analysis tailored to the patient

“The question is: ‘Who is eligible for this therapy?’. The best way to find out would be to conduct double-blind studies, but that is very difficult for both ethical and technical reasons. Instead, we will create two treatment plans for every patient: one based on proton therapy and the other based on conventional radiotherapy. Based on the calculated radiation dose, you can estimate the likelihood of damage to the organs in close proximity to the tumour, which is something we want to minimise as much as possible.”

“We now aim to systematically record the most up-to-date information about the individual patient. We are setting up a model in which every patient will complete questionnaires, so we know exactly what the therapy has achieved and whether damage has been caused. The information will be immediately used in iterative process: the data from each patient treated will provide input for the model and contribute to the quality of the subsequent decision.

In the LUMC, we have developed a method called Adaptive Conjoint Analysis (ACA), which uses a computer program to find out the patient’s preferences. However, it works on the basis of aggregated data from large numbers of patients. That is far too crude. What you really need is an tailored analysis of costs and benefits based on the individual patient characteristics.”

Call in expertise from Delft

“Some studies show that certain patients have a preference for a lower chance of cure, in order to avoid severe side effects. Elderly patients sometimes prefer a less radical approach, whereas young parents opt for the therapy that offers the greatest chance of cure (potentially with a lot of side effects). This shows that doctors shouldn’t decide for their patients, shared decision making is absolutely required. For example, in patients with a tumour in the head & neck region, radiation may cause damage to the saliva glands, or to the muscles involved in swallowing. Currently, the care providers decide how the radiation dose is distributed and what organs are most at risk. But it is possible that a patient would prefer to avoid certain side effects rather than others. He or she could find a dry mouth much more of a problem than issues with swallowing. This information needs to be taken into account in the treatment planning system. That will involve the processing of a lot of complicated data, which is why it is time to call in the expertise at TU Delft.”

“I not only intend to look at EEMCS; Many projects at Industrial Design Engineering could be useful for patients as well. We can no doubt also learn from Technology, Policy and Management about issues such as optimising our logistical processes. I see it as my role to say: this is something that could certainly be useful to us. Or perhaps to pose a question for which we still don’t have an answer, but that matches the expertise at TU Delft.”

“This assignment comes with certain responsibilities. It challenges me to look at things that we have been wanting to change for years and really get things moving now. In my view, that is what the Medical Delta is meant for.”

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