ESTRO 2024 Congress Report

Brachytherapy was present in numerous sessions of this year's ESTRO conference. I had the honour of co-hosting one of them, which discussed proffered papers on brachytherapy for gynaecological cancers.

The room was filled with listeners who participated actively in the meeting. After each presentation, a lively discussion and numerous questions from the participants allowed for a detailed discussion of the topic. Two presentations concerned the treatment of recurrences of gynaecological cancers in the pelvic area. As the patients live longer, we expect to deal more often with re-irradiation. Brachytherapy, which is increasingly called interventional radiotherapy, is an effective weapon in these cases, but there are still no standards regarding the doses or number of fractions to be used. More systematic reporting from brachytherapy departments of treatments would be helpful in the future to create recommendations that will support clinicians.

The hot topic of artificial intelligence (AI) was discussed in this session. Data from automatic cervical cancer treatment planning are promising, and the Brachy Society is waiting for the commercial possibilities of using different tools in daily practice. Such tools would make it possible to shorten the workflow.

Due to limited resources related to personnel access, researchers and clinicians are trying to reduce the number of insertions and increase the doses per fraction, as well as to use single-insertion treatments with more than one session of high-dose-rate brachytherapy (i.e. in Canada, France and India). It is a promising approach but needs validation in larger cohorts.

Memory Bvochora-Nsingo, from Botswana, was met with great applause. She spoke regarding the way in which the training course in image-guided brachytherapy that is organised by ESTRO had impacted positively the beginnings of the development of 3D brachytherapy in her country. Another option that I learned about during the conference is an organised online course for low-to-middle-income countries with a high burden of cervical cancer and limited access to treatment. It is a fantastic initiative that is based on teaching by volunteers and donations that cover the total cost of the online platform.

An interesting virtual-reality training system for interstitial brachytherapy was presented on a digital poster by a group from China. It can be a great support to improve practitioners’ skills. Another approach that is focused on improving the qualifications of the brachytherapy team was presented by a group from Mumbai in cooperation with Brachy Academy. The transition to image-guided brachytherapy six months after the course was shown as a tangible success among radiation oncologists on the project.

Several national scientific posters featured reports on researchers' experiences and treatment results with image-guided adaptive brachytherapy. Many researchers from around the world, e.g., from the Czech Republic, India, Thailand, and Singapore, showed excellent treatment outcomes that confirmed the effectiveness and safety of this method.

After returning to work, I shared my impressions of the congress with my colleagues. The ESTRO application allowed me to replay selected sessions. However, only personal participation enables conversation with lecturers and meetings with fellow radiotherapists and exhibitors. It stimulates me to work better for our patients in the coming year.

Ewa Burchardt, MD, PhD

Greater Poland Cancer Center, Poznan, Poland; University of Medical Sciences in Poznan

ewa.burchardt@wco.pl