Programme

Overview: Over a decade ago, FLASH radiotherapy emerged in the field of radiation oncology with the promise of widening the therapeutic window. While the number of supporting preclinical studies has grown exponentially, technological and biological challenges have slowed its clinical translation, resulting in only a limited number of early-phase clinical trials currently underway. This panel discussion brings together three multidisciplinary experts with experience in clinical translation. They will explore why this promising technique has not yet been widely adopted in clinical practice and discuss the necessary steps and actions to ensure the safe and successful translation of FLASH radiotherapy into clinical use. The discussion will also highlight the importance of veterinary clinical trials and preclinical biology studies in bridging the gap from bench to bedside, ensuring that FLASH radiotherapy's potential is fully realized in both human and veterinary medicine.

Overview: This teaching lecture will focus on motion management strategies specifically when treating oligometastatic disease (OMD) in the thoracic and abdominal regions with SBRT. The lecture will be presented from the viewpoints of both the perspectives of the RTT and the medical physics expert (MPE). The MPE will start the lecture by giving a brief overview of the history of OMD. Concepts such as ITV, MidPos, MidVent and continuous target tracking will be discussed in the line of online adaptive delivery. The MPE will also pose a question over the optimal hardware for such treatment delivery- are ‘traditional’ linear accelerators sufficient or are dedicated, high technology units required? The RTT perspective will take the position of motion management when treating multiple volumes in the same plan on the MR-linac and will refer to the sites most commonly treated in this manner-lung, mediastinum, liver, abdominal volumes and abdominal lymph nodes. The presentation will follow the pathway from pre-treatment to on-treatment, leading to on-treatment decision making by the RTT with specific focus on what planes and which volumes to gate. Finally, some trouble shooting points will be given as well as consideration to questions which are still unanswered in this field.

Overview: Brachytherapy is a promising treatment option allowing organ preservation for penile carcinoma treatments. This teaching session will give an overview starting with anatomy, pathology and the different treatment options. The entire brachytherapy treatment will be presented in detail including the current state of the art in literature, patient selection criteria and the details on the procedure from implant to treatment planning. Outcome data, experience from a leading center and potential future directions will conclude this session.

Overview: This session explores innovative approaches to clinical research in radiation oncology, challenging traditional methodologies and highlighting the need for adaptability in a rapidly evolving field. The first talk discusses the limitations of RCTs, including their high costs, long timelines, and challenges in keeping pace with technological advancements. The second talk examines the role of real-world evidence, defining its scope, regulatory perspectives, and impact on clinical decision-making. The third talk explores pragmatic trials as a bridge between efficacy and real-world effectiveness, addressing their design and implementation. Finally, the session covers the Trials Within Cohort (TwiCs) approach, demonstrating how cohort-based randomised trials can offer ethical and practical advantages. Together, these talks offer a roadmap for modernizing clinical research in radiation oncology.

Overview: This symposium “Radiation Biology of Targeted Radionuclide Therapy” will compare the (immunological) effects of targeted radionuclide therapy to that of external beam radiation therapy, and discuss the differences between alpha and beta radiation. Key topics in radiopharmaceutical development, radiation biology, and therapeutic advancements will be covered, including the radiopharmaceutical pipeline, theranostic applications, clinical translation, and patent considerations. Auger electrons will also be introduced, highlighting their therapeutic potential and recent research findings. Collectively, this symposium will offer valuable insights into the evolving field of targeted radiation therapies and their clinical impact.

Overview: A substantial part of the head and neck patients are more than 70 years of age at diagnosis. This calls for special considerations when deciding the treatment in collaboration with the patient and the relatives. Who can be treated according to international guidelines? Who needs a modified curative regime (and what can that be in terms of radiotherapy and/or systemic treatment) and for whom is palliation the best choice? How do we decide and what outcomes can be expected? After the session, the attendee will have a good overview of this challenging topic.

Overview: This symposium explores the role of quantitative MRI biomarkers in radiation therapy (RT) response assessment, with a focus on their validation for multicenter clinical trials. Experts will discuss the integration of biological image-guided adaptive RT, standardization of MRI sequences, and robust parameter extraction across institutions. The session will also highlight the potential of deep learning in MRI parameter estimation and the role of hypoxia imaging in clinical trials. A panel discussion will address challenges and opportunities in advancing MRI biomarkers for precision RT.