Programme

Overview: In radiation oncology, treatment decisions require balancing therapeutic efficacy with the risk of toxicity. Normal Tissue Complication Probability (NTCP) models offer a quantitative framework for estimating treatment-related side effects, potentially enabling safer, more personalized care. However, whether they should take the lead in clinical decision-making remains a matter of debate. Arguing for the motion, Markus Alber and Hans Langendijk will advocate for NTCP models as essential tools for guiding patient management. Opposing them, Tiziana Rancati and Ivan Vogelius will highlight model limitations and question their reliability. The stage is set for a compelling debate—but who has the stronger arguments? That’s for you, the audience, to decide!

Overview: In this debate 4 renowned clinical physicists will debate whether or not we still need a routine patient/plan specific quality assurance (PSQA) measurements. With the introduction of complex radiotherapy techniques like IMRT, VMAT and stereotactic radiotherapy in the beginning of this century and uncertainties associated with small field dosimetry, MLC modelling in TPS, etc. have increased the demand for PSQA. The provision of commercial PSQA tools lead to intensification of PSQA. PSQA has certainly increased our quality and safety of complex radiotherapy techniques. Over the years, radiotherapy delivery machines have become more stable. Also, treatment planning dose calculations have become more accurate. Moreover, data transfer is exceedingly automated, reducing the chance on human errors. As such, it seems the treatment delivery process might be “in control”. This would mean that, if the treatment techniques are properly commissioned, measurement based PSQA would become less important. Is this true? Come to this debate and let your opinion count! Arguments for and against continued measurement based PSQA will be shared and you can vote who has won the debate.

Overview: Positioning and immobilisation are fundamental steps in the RT patient pathway, uniquely vital for ensuring treatment reproducibility and precision. RTT experts will argue for and against the proposition considering traditional immobilisation strategies in light of advancements such as Surface-Guided Radiotherapy (SGRT), particle therapy, and online ART. Proponents argue that modern technologies and techniques reduce reliance on rigid immobilisation, enhancing patient comfort and experience. Opponents caution against abandoning these proven methods, emphasizing the risks of excess external and internal motion and misalignment without robust positioning systems. Join this engaging session as we discuss the evolving role of immobilisation in RT and its implications for patient care and daily practice.

Overview: In the last years, MR-Linac research, translation and clinical application was the dominating innovation in RT. With the recent introduction of new CBCT-guided linac hardware in combination with streamlined adaptive workflow, the dominance of MR-Linacs in the online-adaptive context might change. Will MR-Linacs completely vanish? Or will they become a niche application like Cyberknife or others? Or will the superiority of the MR-guidance lead to breakthrough-applications? What are the advantages and disadvantages of CBCT-guided online adaptions? What do you think – will CBCT-based fast adaptation workflows will supersede broad MR-Linac usage? Will our four debaters change your opinion? What will be the majority vote?

Overview: In many curative fields of radiation oncology, the need of large fields of irradiation comprising elective nodal volumes has been scrutinized over the last years. In head and neck cancer, the inherent lymphophylic behavior of head and neck squamous cell carcinoma has traditionally mandated the practice of neck management, in parallel to standard practice in head and neck surgery. Based on recent trends of research, spanning from new approaches in nodal staging to the integration of AI-based models, the concept of ENI has been questioned. Is it time for a major shift from standard practice in head and neck radiotherapy?

Overview: In fractionated radiotherapy, the dose delivered each day varies between treatment sessions. In current clinical practice each fraction is evaluated separately to allow for the evaluation of dosimetric changes of even the necessary adaptations to the treatment plan. Dose accumulation enables tracking of the total dose throughout the treatment. However, due to large and poorly quantified uncertainties, interpreting accumulated doses remains challenging and is currently limited in clinical practice. This debate will explore whether dose accumulation could provide a clinical benefit in future radiotherapy.