[UPDATE] Image-Guided Radiotherapy and Chemotherapy in Gynaecological Cancer: Focus on MRI Based Adaptive Brachytherapy

Lisbon, Portugal


ESTRO is monitoring closely the evolution of the COVID-19 pandemic. Any updates regarding the specific format of this course ( live vs virtual) will be available shortly on this website.

We thank you for your understanding and we look forward to your participation!

The ESTRO School Team

[ Early deadline: 11 June 2020 ]

This course will offer two parallel tracks tailored to general and experienced levels. You will just have to choose the one made for you… Mark your calendars! 

The course is aimed at radiation and gynaecology oncologists, medical physicists and radiation therapists (RTTs) involved in gynaecological tumour treatments, interested in the implementation of EBRT and brachytherapy image guidance. Course participants should have specific interest in and/or initial experience with implementation of advanced MRI based brachytherapy and advanced EBRT techniques (IMRT/IGRT). The course offers both a “General track” and an “Experienced track” to meet different levels of clinical experience.

Course Directors

  • Richard Pötter, Radiation Oncologist, Medical University Hospital, Vienna (AT)
  • Kari Tanderup, Medical Physicist, University Hospital, Aarhus (DK)


  • Ina Jürgenliemk-Schulz, Radiation Oncologist, University Medical Centre, Utrecht (NL) 
  • Umesh Mahantshetty, Radiation Oncologist, Tata Memorial Hospital, Mumbai (IN)      
  • Nicole Nesvacil, Medical Physicist, Medical University Hospital, Vienna (AT) 
  • Remi Nout, Radiation Oncologist, Erasmus Medical Center, Rotterdam (NL) 
  • Primoz Petric, Radiation Oncologist, Aarhus University Hospital (DK)                    
  • Jamema Swamidas, Medical Physicist, Tata Memorial Hospital, Mumbai (IN) 
  • Li Tee Tan, Radiation Oncologist, Addenbrooke’s Hospital - Oncology Centre, Cambridge (UK)

Guest Faculty

  • Simon Duke, Radiation Oncologist/PhD Student, Addenbrooke´s Hospital- Oncology Centre, Cambridge (UK)
  • Monica Serban, Medical Physicist, McGill University Health Centre, Montreal (CA)

Local Organiser

Lurdes Trigo, Radiation Oncologist, Instituto Português de Oncologia do Porto Francisco Gentil, EPE, Porto 

The course aims to: 

  • Teach about principles of 3D image-based EBRT and brachytherapy including techniques and treatment planning in gynaecological cancer
  • Provide understanding of commissioning, quality assurance, principles of planning, plan evaluation and reporting of 2D and 3D brachytherapy with focus on cervical cancer
  • Introduce 3D image-based (adaptive) target concepts of GTV, CTV and PTV including both EBRT and brachytherapy with focus on cervical cancer
  • Enable practical implementation of 3D techniques in EBRT and brachytherapy with focus on cervical cancer
  • Provide an overview on radiation therapy (external radiation and brachytherapy) and clinical outcome in gynaecological cancers.
  • Enhance the practical implemention and logistics for transition to 3D/4D in the existing environment.
  • Provide further roadmap and steps of intervention to improve the existing standards

Learning Outcomes

By the end of this course participants should be able to:

  • Understand the rationale of 3D and apply concepts of advanced brachytherapy techniques in clinical practice
  • Perform contouring and treatment planning for 3D image guided EBRT and brachytherapy in clinical practice
  • Implement procedures for 3D image guided brachytherapy focussed on cervical cancer in own department
  • Implement advanced EBRT techniques in cervical cancer in own department.
  • Give feedback and review of hurdles in implementation

Course Content

  • Normal, pathologic anatomy and clinical examination of female pelvis 
  • Image based anatomy including US, CT, MRI and conventional radiography
  • CTV/ITV/PTV for external irradiation
  • Combination of external irradiation and brachytherapy
  • Different application techniques in brachytherapy
  • Commissioning and Quality Assurance of various processes involved in 3D treatment planning.
  • Application techniques in brachytherapy including combined intracavitary-interstitial applicators
  • Treatment planning for brachytherapy
  • ICRU 89 concepts: GTV, CTV, PTV at diagnosis and at time of brachytherapy for 2D and 3D brachytherapy (adaptive target concept)
  • Dose, dose-rate and fractionation and overall treatment time
  • Radiobiological effects from combined external irradiation and brachytherapy, linear quadratic model
  • Prescribing, recording and reporting including ICRU 89 - GEC-ESTRO recommendations and ESGO/ESTRO/ESP guidelines for the management of patients with cervical cancer
  • Therapeutic outcome: radio-chemotherapy, image based EBRT and brachytherapy including EMBRACE
  • Reflexion of participants` clinical experience in image guided radiotherapy (experienced track)
  • Two different tracks will be offered which are adapted to different levels of clinical experience among participants: “General track” and “Experienced track”. The major part of the programme will be joint sessions, while break-out sessions for the two tracks will amount to a total of 5.5 hours distributed on day 2, day 3 and day 4. “Experienced track” can maximum accommodate 20 participants.

The "General track" has a more elaborate educational component and will include all introductory lectures into image guided brachytherapy such as brachytherapy techniques, target contouring, and ICRU 89 - GEC-ESTRO recommendations.

The “Experienced track” will feature break-out sessions where each participant (or optimally a team of MD and physicist/RTT from one department) present a patient case on power point (diagnostic work-up, EBRT target contouring and treatment planning as well as brachytherapy application, target contouring and treatment). Templates for case presentations will be available and these should be used to prepare a 15 minutes presentation of the case. The break-out sessions will be supervised by faculty members (MDs and physicists), so that individual feed-back on treatment practice can be obtained.


Depending whether you opt for the general or experienced track, slightly different prerequisites will apply. These are detailed above.

Teaching Methods

Description: The tutorials include discussions of basics, evidence based treatments, contouring guidelines, various processes involved in advanced EBRT and brachytherapy techniques and quality assurance. The practical hands on demonstration covers a direct learning process involved in approach, brachytherapy techniques, contouring exercises, evaluation and discussions on 3D radiotherapy.

Methods of Assessment

  • Lectures: 16 hours
  • Applicators commissioning and reconstruction: 6 hours - Physicists
  • Practical workshops: 8 hours
  • Video presentations by faculty???: 2-3 hours – Clinician Pre-course questionnaire
  • Registration sheet for decision on general track versus experienced track
  • Contouring (FALCON tool) and dose planning exercises (pre- and post-course homework) 
  • Interactive feedback through audience voting on specific questions during lectures
  • MCQ (interactive session at the end of the course)
  • ESTRO teaching course evaluation form 
  • Exclusive feedback sessions for “Experienced track” participants



 Draft programme available here

Key Words

  • Evidence based multi-modality management guidelines
  • 2D to 3D transition
  • 3D Image Guided Adaptive Brachytherapy (IGABT) in cervical cancer
  • Contouring guidelines for advanced EBRT including IMRT/ IGRT and image based brachytherapy with focus on cervical cancer

Further Reading

Will be specified under Learning Objectives (available for participants after registration on ESTRO Moodle)


Application for CME recognition will be submitted to the European Accreditation Council for Continuing Medical Education (EACCME), an institution of the European Union of Medical Specialists (UEMS). EACCME credits are recognised by the American Medical Association towards the Physician’s Recognition Award (PRA). Information on the status of the applications can be obtained from the ESTRO office.


Ramada by Wyndham Lisbon

Avenida Engenheiro Arantes Oliveira N° 9

Lisboa 1900-221 – Portugal

Tel: (800) 854-9517


Participants can book rooms at the Ramada Lisbon Hotel at preferential rates.

Price changes from legislation are borne by the ultimate consumer.

To book a room please fill in the accommodation form and send it back to meetingpoint@meetingpoint.pt

Note that only a limited number of rooms is available and will be granted on a first come first served basis



ESTRO members can order products at substantially reduced prices. Please note that in order to benefit from the member price, you must renew your membership for 2020 before registering to the course.To benefit from these member rates, please visit the membership page to become a member or renew your membership BEFORE proceeding with your order.



Early rate

Late rate

In-training members*   500 EUR  675 EUR
Members   650 EUR   775 EUR
Non Members   800 EUR  900 EUR

* Members with specialty RadiationTherapist (RTT) may register at the In Training fee

Early rates are applied up to three months before the starting date of the course. 
Late rates are applied three months before the starting date of the course.

The fee includes the course material, coffees, lunches, and the social event.

Advance registration & payment are required.

On-site registration will not be available.

Since the number of participants is limited, late registrants are advised to contact the ESTRO office before payment, to inquire about availability of places. Access to homework and/or course material will become available upon receipt of full payment.

Insurance and cancellation

The organiser does not accept liability for individual medical, travel or personal insurance. Participants are strongly advised to take out their own personal insurance policies.   

In case an unforeseen event would force ESTRO to cancel the meeting, the Society will reimburse the participants fully the registration fees. ESTRO will not be responsible for the refund of travel and accommodation costs.

In case of cancellation, full refund of the registration fee minus 15% for administrative costs may be obtained up to three months before the course and 50% of the fee up to one month before the course. No refund will be made if the cancellation request is postmarked less than one month before the start of the course.

Reduced fees

ESTRO members from economically challenged countries may register at a preferential rate of 350 Euro if three conditions are met:

  1. Only ESTRO members for 2020 are eligible (please make sure your 2020 membership is in order before you apply for the reduced fees)
  2. Only one course per person per year can be subsidized by ESTRO
  3. Sponsored candidates are not entitled to reduced fees (the invoicing address has to be the one of the participant)  

Please note: 

  • We can only guarantee a certain number of reduced fees per course
  • Application deadlines are the same as early registration fees (3 months before the course date

List of Economically challenged countries and eligible courses