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Adaptive Radiotherapy Focus Group

The ESTRO Focus Group on Adaptive Radiotherapy is established to support the safe, effective, and coordinated development of adaptive radiotherapy across technologies, tumour sites, professional groups, and clinical environments.

The Focus Group serves as a multidisciplinary platform within ESTRO, helping to identify key clinical, technical, educational, and organisational needs as adaptive radiotherapy moves from research and early clinical implementation towards broader routine use.

Its scope includes online, offline, and triggered adaptive radiotherapy across photon and particle therapy, with a focus on clinical implementation, workflow design, quality assurance, education, reporting, evidence generation, and multidisciplinary collaboration.

The Focus Group supports ESTRO Councils and Committees by proposing and contributing to educational activities, guidance documents, workshops, surveys, consensus initiatives, and scientific content related to adaptive radiotherapy. Where topics overlap with other ESTRO groups, the Focus Group will aim to collaborate and contribute from the specific perspective of adaptive radiotherapy.

Core fields of interest

  • Online and offline adaptive radiotherapy
  • Scheduled and triggered adaptive radiotherapy
  • CT-, CBCT-, and MR-guided adaptive workflows
  • Adaptive photon and particle therapy
  • Clinical workflow design and implementation
  • QA, commissioning, and safety of adaptive workflows
  • Professional roles, training, and multidisciplinary decision-making
  • Evidence generation, clinical value, scalability and health-economic evaluation

 

Cross-cutting areas in adaptive radiotherapy

  • Imaging for adaptive decision-making
  • Auto-contouring, contour propagation, and plan adaptation
  • Dose accumulation, deformable registration, and uncertainty management
  • AI and automation to support scalable adaptive workflows
  • Biological and response-adapted radiotherapy
  • Reporting, documentation, and harmonisation of adaptive practice

Co-Chairs:
Francesca Albertini, Medical Physicist, Paul Scherrer Institute, Villigen (CH)
Pieter Populaire, Radiation Oncologist, University Hospital Leuven  (BE)
Rita Simões, RTT, The Royal Marsden NHS Foundation Trust, The Institute of Cancer Research (UK)

The Focus Group defines its detailed activity plan together with the selected core members. Activities under consideration include (in random order):

  • Defining roles, responsibilities, and workflow models for adaptive radiotherapy, including curricula and training needs for RTTs, medical physicists, and radiation oncologists.
  • Developing activities on reporting and prescription in adaptive radiotherapy.
  • Establishing a webinar series on adaptive radiotherapy, including sessions developed together with the RTT community.
  • Supporting a practical “How to…” activity on synthetic CT QA and commissioning for adaptive radiotherapy, initiated by EPTN and potentially developed in collaboration with the ESTRO Imaging Focus Group.
  • Contributing to harmonisation of nomenclature and terminology in adaptive radiotherapy.
  • Exploring a (Delphi) consensus process on indications and treatment scenarios most suitable for adaptive radiotherapy, potentially in collaboration with other relevant Focus Groups, for example in hypofractionated treatments.
  • Developing educational activities and implementation-oriented material to support centres starting or expanding adaptive radiotherapy programmes.
  • Supporting surveys, workshops, guidance documents, and scientific sessions addressing barriers, priorities, and best practices in adaptive radiotherapy.