Predicting and evaluating side effects of radiotherapy in cervical cancer

Corbeau, A. (2026)

Doctoral Thesis

Each year, approximately 300 women in the Netherlands are diagnosed with locally advanced cervical cancer. The standard treatment consists of external beam radiotherapy combined with chemotherapy, followed by brachytherapy. However, women may experience side effects affecting the intestines, bladder, and vagina. Additionally, damage to the bone marrow can lead to a decrease in the number of immune cells in the blood, potentially weakening the immune system. Two techniques, bone marrow sparing and proton therapy, may help reduce these side effects.
In this thesis, models were developed to predict treatment-related side effects. These models may help radiation oncologists identify which patients have a higher risk of developing side effects. Furthermore, the studies in this thesis show that the current treatment leads to an increased fat content in the bone marrow and reduces both the number and function of immune cells, despite the use of bone marrow sparing techniques.
These findings suggest that bone marrow sparing should be further improved and that proton therapy may help reduce bone marrow damage. Overall, this thesis contributes to improving and evaluating these techniques for patients with locally advanced cervical cancer.

• Cervical cancer
• Radiotherapy
• Side effects
• Toxicities
• Normal Tissue Complication Probability models
• Hematologic toxicity
• Bone marrow damage
• Proton therapy

• All authors: Corbeau, A.
• Supervisor: Creutzberg, C.L.; Nout, R.A.
• Co-supervisor: Boer, S.M. de
• Committee: Smit, V.T.H.B.M.; Astreinidou, E.; Boersma, L.J.; Hoogeman, M.S.
• Qualification: Doctor (dr.)
• Awarding Institution: Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
• Date: 2026-04-02
• DOI: doi:10.60602/1887-4300428
• Sponsorship: Varian Medical Systems, Inc., a Siemens Healthineers Company