Programme

Overview: This teaching lecture is about the need for rapid response palliative care, and the benefits of making this an RTT led service. The knowledge, skills, competence required by RTTs to lead this service will be discussed, including the use of MRI linac and possibilities in performing research. Also, indications for the role of radiotherapy in palliative care will be discussed, looking at prediction scoring systems, aspects of shared decision-making, and, the benefits of working together in a multi professional team.

Overview: In proton therapy, a fixed relative biological effectiveness (RBE) of 1.1 is used worldwide for all fraction sizes and all tumor sites. However, recent experimental data show that the RBE increases significantly towards the distal edge of the treatment field, and several models parameterize the RBE as a function of linear energy transfer (LET). Clinically, an increased RBE may have detrimental effects on normal tissue; however, the clinical evidence for this is still limited. The use of variable RBE in proton therapy is therefore controversial. After a brief introduction, the present status, possible clinical implications and strategies will be discussed.

Overview: The Joint Symposium (ESTRO-EADO) will focus on different aspects of skin cancer treatment highlighting the importance of close cooperation between dermato-oncologist, radiation oncologist, surgeon and onco-geriatrician. Indeed, the modern management of melanoma and non-melanoma skin cancer needs a continued mutual understanding of advancements in each speciality allowing to work together towards a common goal. Therefore, a short overview of EADO-ESTRO activities, leading to MoU (Memorandum of understanding), will be presented in order to remark the way of increased cooperation between the two organisations. During the session, the most recent advances in skin oncology approach will be discussed. In particular, the new and ongoing studies with promising results for melanoma, basal cell carcinoma and cutaneous squamous cell carcinoma with special focus on systemic therapies, radiation therapy and surgery also considering the modern integration approach. Finally a special discussion will be done about the management of older patients with skin cancer, presenting the epidemiology of skin cancer in older adults focusing on frailty and impact on management and reporting the recently published SIOG guidelines.

Overview: During the next meeting in Glasgow, we would like to talk a little bit about quality of life after cancer treatment. During the session, you will be able to hear about the differences between the needs of the individual patient and the clinician and how to find a balance between them regarding the various priorities among individuals. Quality of life regarding late cancer treatment side effects, as well as recognition and reporting of them, will be discussed. What is more, you can hear about some unmet needs, like intimacy, sexuality and emotions, during and after cancer. At the end, you will find some tips and tricks about how to stay fit during the treatment and afterward, which could help your patients stay active. See you soon!

Overview: Treatment for rectal cancer has evolved from a “single approach suits all” strategy to a multidisciplinary, tailor-made treatment with or without surgery. As such, radiotherapy can play a variety of roles in the rectal cancer journey, asking for personalized choices per patient. For example, in early stages, it may even be the only treatment modality followed by a watch and wait strategy or local excision. In the locally advanced setting it can be tailored to the specific patient's risk category and needs with intensification or personalization of RT dose and volumes, with or without the addition of systemic treatment. The approach for local recurrence requires a completely different mindset, depending on previous treatment and treatment aims, whereas in the oligometastatic patient it can offer a chance to a non-invasive disease control in synergy with systemic therapies. This shows that to ensure optimal treatment for every rectal cancer patient, a thorough understanding of all possibilities is needed. This symposium will provide you with an overview of the optimal treatment for these different disease stages.

Overview: Radiation induced normal tissue toxicity from proton therapy observed mainly in Brain and Head and Neck cancer patients is a serious problem that requires a multidisciplinary effort to better understand the underlying radiobiologic cause. In this session the speakers with various foci will give us insights into different imaging modalities ( quantitative MRI and PET) for lesion evaluation, differentiation between pseudo progression, tumor progression and radiation necrosis. Furthermore, modeling voxelwise risk of lesion occurrence using statistical/AI methods and how this can be transferred to predict a patient level risk of radiation necrosis will be presented and how these models may influence treatment planning strategies. Finally, preclinical imaging of normal tissue toxicity allowing for avoidance of unclear contributions from tumor response allows for greater insight of the underlying radiation sensitivity effect in the rodent brain. Together, these presentations illuminate our evolving understanding of the serious radiobiological effect seen in high dose regions following proton therapy.