On the occasion of the 75th Antziveraary of The Netherlands Cuncer Institute (Antoni van Leeuwen- hoekhuis), this special issue contains contributions from members of the Radiotherapy Department, covering the spectrum of clinical studies, radiobiol- ogy and physics. The papers represent work from the Institute i&elf as well as from collaborations with other institutes*. This brief introduction sketches the historical development of the Institute.

In 1913 it was decided to found a national insti- tute dedilcated to the treatment and research of can- cer and to associate the institute with the name of Antoni van Leeuwenhoek. Antoni van Leeuwen- hoek (1632-I 723), an original and progressive Dutch scientist in his lifetime, can be considered one of the founders of microbiology. .He made many discoveries in the field of living micro-organ- isms with small self-made microscopes. e used tiny lenses which he ground himself and with which he could obtain enlargements of up to 270 times. Van Leeuwenhoek described his scientific observa- tions in letters to the Royal Society itz London, of which he became a member in 1680.

The Netherlands Cancer Institute was originally situated in a former merchant’s residence on one of the Amsterdam canals (Fig. 1). In 1925 the institute moved to a former military hospital in Amsterdam (Fig. 2), where it stayed for almost 50 years. During the 1970’s it was moved to its present site in the west of Amsterdam (Fig. 3). It now consists of a large hospital connected to an equally large &floor research wing. Growth in the 75 years has been con- siderable! In 1914 there were 17 beds and 17 co-

* All papers included in this issue have been subjected to the normal peer review procedure of the journal.

workers; at present the numbers have increase

180 beds and 1000 co-workers. The interaction between clinic an

has been a special feature of he Netherlands Can- cer Institute from the start and has been maintained over the years. Likewise, the m~Itidisci~~~~nary ap- proach in treatment of cancer arients was the b principle from the beginning nd is still the gu line today.

In the Radiotherapy new patients with malignant diseases will be treated this year. These patients come not only from Am- sterdam but from all over The Netherlands, a re- ferral pattern reflecting the regional and national function of the Cancer Institute.

The first radiotherapist appointed in 1914 was Gaarenstroom. who devoted much of his attention to brachytherapy with radium. e performed im- plants in the oral cavity, tonsil, lymph nodes and also local applications of radium sources to various sites, such as skin, oesophagus, rectum and the uterus. External radiation was also given, using or- thovoltage X-ray equipment. On the initiative of Den Hoed, the first megavoltage apparatus in Europe was installed in the Institute in 1939, nick- named “the millionaire” (Fig. 4). With this appar- atus it was possible to irradiate three patients at a time! Due to wartime conditions this apparatus was never able to fulfil its promise. Under Lokkerbol, a large telecobalt machine mounted on a wheel and designed for treatment through the couch. was built and began operating in 1959.

reur became chairman of the de ment and was appointed at that time as the Professor of Radiotherapy in The Netherland stimulated the practice of radiotherapy in many

0167-~I4Oj8S~$O3.50 @ 1988 Elsevier Science Publishers B.V. (Biomedical Division)

Fig. I. The Netherlands Cancer Institute: originally situated in a former merchant’s residence on one of

the Amsterdam canals.

Fig. 3. The Netherlands Cancer Institute (Amsterdam west): present site.

Fig. 2. The Netherlands Cancer Institute (1925): former military hospital, Amsterdam.

Fig. 4. The first megavoltage apparatus in Europe: installed in the Institute in 1939 and nicknamed “the

millionaire”.

VI?

ways, especially by his careful clinical approack and by his positive attitude to experimental research Breur’s activities were not con to Arnster~~~~~ since he also played a major internationally.

e was, for example, one of the founders of the European Organisation for Research and Treatment of Cancer (EORTC) and participated actively in cooperative groups. e was active in establishing a radiotherapy branch in the International Societ? of Radiology. At the same time, he promoted the birth of an independent radiotherapy organisation, resulting in the foundation of the European Society for Therapeutic Radiology and Oncology (ESTRO) . Clinical research took place from the beginning and even in the early days interest was directed at ra- diobiology. This was clear from the first publication from The Netherlands Cancer Institute, which with the treatment of carcinoma with X-ray radioactive compounds. In 1938, Den Hoed [l] published one of the first articles on the biological effects of neutrons in which he concluded that neu- trons caused more damage than X-rays: for equal injury to normal tissues three times the X-ray dose had to be given compared to neutron doses. petted a therapeutic gain, however, because he be- lieved that malignant turnout-s were four times more sensitive to fast neutrons than to X-rays. As the knowledge of the radiobiological basis of neutron radiation increased in the 1960’s, interest revived in the clinical application of fast neutrons. The mea- surement of lung metastases after irradiation with X-rays or fast neutrons by Breur led to the install- ment of a neutron generator in The Netherlands Cancer Institute in 1974. 450 patients were treated in a period of about 5 years, mostly within random- ised trials.

Subsequent clinical research has moved away from treatment with fast neutrons to, among others, the interaction of radiotherapy and chem- otherapy, with particular focus on the use of cis- platin as a radiosensitizer. Results from the labo- ratory have led to clinical trials. mostly carried out

TC. At the same time, the io- ment has taken part in the devel-

ent of patients with early an east cancer.

The high demand for accurate atient treatment has led to the development of methods for quality

control in which the Jnstitute is now heavily in-

th the actual dose delivery nd the positioning of the

nt are now being systematically rent treatment techniques. For

ose. a digital megavoltage image de- tector is under development. ther current resear activities of the radiation physics group concern t

clinical application of dose calculatiotl mo the dosimerry of photon and fast electron under nditions.

The epartment also incor an active radiobiology group carrying out on, among others, measurement of human tumou; cell kinetics with IUdR and flow cytometry and the detection of radiation damage in ormal tissues by assessment of chromosomal and NA lesions. The experimental radiotherapy group benefits from its position in a research institute with a solid tradition in molecular biology and cell biology.

We are grateful to the Editorial therapy arzd Oncology for the opportunity to outline recent work in this issue and in this way to com- memorate the 75th Anniverssary qf Tlfe Netherlands Cancer Institute.

J.A. Bangert

eferences

I Den Hoed, D. The biological effects of neutrons. Radiologica 3: 65-73, 1938.

2 Gaarenstroom, G. F. Over de behandeling van kanker met riintgcnstralen en radio-actievc stoffcn. Ned. Tijdschr. Ge- neeskunde. 58: 1030-1055. 1914.