​Follow-up studies of long-term chilhood and adolescent/young adult cancer survivors have documented a treatment-induced increased mortality and morbidity, primarily from cardiovascular disease and second cancers. Many of these late effects are radiation-induced.

The aim is to improve the outcome for pediatric cancer and breast cancer patients by

1. refining the criteria for selecting patients for radiotherapy, 
2. reducing the healthy tissue radiation exposure among those who receive radiotherapy, 
3. optimizing the follow-up strategies of survivors, and 
4. performing personalized risk prediction to limit the toxicity of treatment.
   

Main research areas

• The use of radiotherapy in the curative management of some pediatric and breast cancer patients is being limited. In this situation, information on the precise localization of relapses and the spatial relationship to the initial disease localization is crucial to better define the optimal radiation volumes for patients in the future.

• In radiotherapy planning, margins are added to the tumor volume to ensure an adequate coverage over the entire treatment time. A decrease in margins may be achieved by applying image-guided RT (IGRT), introducing deep inspiration breath-hold (DIBH), and optimizing delivery techniques.

• Due to the favorable prognosis, and the corresponding long life-expectancy, the impact of late effect(s) on subsequent quality of life, morbidity, and – ultimately – mortality is important. In this context, it is necessary to document both the physical as well as the psycho-social effects of specific treatments to better design and individualize follow-up programs.

• Personalised prevention through detection of actionable chronic diseases may improve outcomes of treatment as well as quality of life in survivors. From readily available data in the individual radiotherapy planning CT-scans, risk prediction by trustworthy AI systems can be tested.​

Researchers​

• Maja V. Maraldo, MD, PhD, Group Leader
  
• Daniella Østergaard (PhD student), 
• Sidsel Jacobsen Juul (PhD student), 
  
• Sára Rossetti (PhD student), 
  
• Frederik Voigt Carstensen (PhD student).​
  

Funding​

Key collaborators

We have well-established collaborations and perform clinical trials within the Danish Breast Cancer Group (DBCG), Danish Pediatric Hematology/Oncology Group (DAPHO) and Nordic Pediatric Hematology/Oncology Group (NOPHO), as well as research projects within 

• ARTILLERY consortium
• ESTRO Guidelines Committee breast cancer sub-group
• Pediatric IGRT group
• EORTC lymphoma group​​​
  

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