ESTRO 2022

Session Item

Sunday

May 08

08:45 - 10:00

Auditorium 15

Personalised radiotherapy: Improving standards of care with personalised treatments

Co-Chair: Sarah Barrett, Ireland;

Chair: , Switzerland

Overview: Firstly, the RTT perspective of personalised radiotherapy is explained, in the context of head and neck treatment. The technological, medical, and social aspects of personalised treatment are assessed. Next, we shift focus to the palliative setting examining personalised radiation therapy for those patients presenting with metastatic spinal cord compression and bone metastasis. The supportive care options are presented as well as relevant treatment planning considerations. The third part of this session highlights radiomics in head and neck RT. Current, novel and emerging application of radiomics will be appraised. This talk will review lessons learned so far which will inform the future recommendations in relation to this technology.

Session Type: Symposium

Track: RTT

Journey:

09:10 - 09:35

Personalised treatment (or care) in palliative radiotherapy

Speaker: , Denmark

Presentation Number: SP-0377

Abstract

Abstract Title:

Personalised treatment (or care) in palliative radiotherapy

Authors:

Vanja Gram¹

¹Rigshospitalet, Department of oncology, section for radiotherapy, Copenhagen, Denmark

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Abstract Text

The vertebral column is the most commonly affected site of metastatic cancer, occurring in approximately 5-10% of cancer patients. Palliative radiotherapy is given to alleviate symptoms and sustain quality of life for patients with advanced cancer. Acute adverse effects from the radiation therapy may however contribute to reducing quality of life, contradicting treatment intention.

For patients receiving palliative irradiation for metastatic spinal cord compression, acute adverse effects commonly occur in the gastro-intestinal tract, causing symptoms such as pain or soreness in the throat, reduction or loss of taste sensation, abdominal discomfort and diarrhea.

Palliative radiotherapy is typically given with an AP/PA beam or a single arc and may or may not be assisted with image guidance.
Advanced radiotherapy techniques offer the possibility of personalising radiotherapy. Personalised radiotherapy is used extensively for curative patients. For palliative patients, who often are offered very standardised treatment options, there are options of treatment personalisation, which are easy to implement clinically.
Options of personalising palliative treatment include (daily) image guidance, arc therapy, organs at risk delineation, fractionation adjustment according to primary diagnose and advanced disease and adjusting to patient wishes.

It is possible to significantly reduce dose to organs at risk. Research has shown effective dose reduction to the bowel through organ at risk delineation. Our research with reducing oesophageal dose for patients with metastatic spinal cord compression showed a mean dose reduction of 29,1% without PTV compromise and up to 50,4% dose reduction with a PTV compromise. Furthermore, modern delineation tools offer this possibility in less than 10 minutes pr patient, making this an inexpensive opportunity of offering personalised radiotherapy to reduce acute toxicity.