Programme

Overview: Learning Objectives: • Understand the major geometrical uncertainties in radiotherapy • Understand how geometrical uncertainties affect the probability of delivering the prescribed dose • Understand how to quantify geometrical uncertainties • Providing and demonstrate some tools to calculate geometrical uncertaintie (Excel) • Understanding caveats in calculating and comparing geometrical uncertainties • Understand how NOT to calculate and report geometrical uncertainties

Overview: Imaging biomarkers from CT, MRI and PET offer the promise of personalizing radiation oncology. In this joint symposium between the European Society of Radiology (ESR) and ESTRO, the work that is required to bring this promise to reality, will be addressed from a multi-disciplinary perspective. The physicist will address the technical challenges and standardization efforts, whereas the radiation oncologist will discuss the clinical potential of imaging biomarkers. The RTT will describe her role in integrating imaging in the radiotherapy workflow. Finally, the imaging expert will discuss how AI can be harnessed to develop prediction models based on imaging biomarkers.

Overview: Vaginal cancer is a rare and challenging disease. To date there is no uniform European guidance for its optimal management with strong variations between the national and international guidelines. A multidisciplinary approach with coordinated collaboration between the different disciplines such as surgery, radiotherapy, medical oncology and pathology is key for optimal patients’ management. For those reasons the three major societies: ESTRO ESGO and SIOPE have worked together to develop and launch guidelines for this rare disease in adults and children/ adolescents in an effort to standardize and homogenise clinical care.

Overview: Fractionation for breast cancer has changed significantly over the years. Due to the publication of the FAST FORWARD trial and the COVID-19 pandemic the ultrafractionation (5-fraction regimen) was introduced in clinical practice since 2020. Because of potential serious toxicity many still are reluctant to adopt shorter fractionation schemes for chest wall and regional lymph node irradiation. In addition, this also accounts for patients with immediate breast reconstruction after mastectomy. In this session, leaders in breast radiation therapy will discuss the evolution of fractionation for breast cancer and important clinical implications and how to move FAST FORWARD safely.

Overview: Modelling is playing an increasing role in the implementation of personalized radiotherapy at a key time when maximizing the immune response is sought. In this session, Pr. R. Mohan will present innovative work based on advanced statistical and machine learning techniques to identify causal factors of radiation-induced lymphopenia, with the ultimate goal to develop "personalized" models predicting the risk of radiation-induced lymphopenia. Complementarily, Pr. C. Grassberger will summarize research on dynamic blood flow modelling to decipher the role of irradiation of the circulating blood in explaining radiation-induced lymphopenia. Work on mathematical modelling of tumor responses in combined immunotherapy/radiotherapy regimens and to oncogene-targeted agents will also be presented. The final presentation, by Pr. I. Toma-Dasu, will focus on dynamic modelling of tumor oxygenation and its application to tumor control predictions. A brief overview of tumor re-oxygenation modelling based on functional imaging of tumor hypoxia will close the session