23-27 March 2025, Maastricht, The Netherlands

I am a medical physicist at Humanitas Research Hospital in Milan, Italy. I have 15 years’ experience of photon radiotherapy, mainly focused on volumetric modulated arc therapy planning and dosimetry. A couple of years ago I started to become interested in particle therapy, since our centre is installing a new proton facility that will go live at the end of 2025.

I decided to attend this course for three main reasons. Firstly, it seemed a good opportunity to gain an overview of the main aspects of particle therapy from very qualified teachers. The second reason was the chance to visit the important proton facility at the Maastro clinic, and the third was the “hybrid” clinical and physical approach of the course. This helped to show the whole picture from another perspective and for me it was a nice chance to discuss these topics with radiation oncologist colleagues who attended the course with me.

One aspect that was touched on both in some presentations and in the journal club particularly got my attention: how to deal with and interpret robustness. The journal club is a yearly session where students read and discuss selected articles — this year, one clinical and one physics paper — with student-led presentations followed by group discussion. This is something important within the daily practice of particle therapy but not always completely understood. Marco Schwarz helped us to navigate through some interesting questions: what are we accounting for when we optimise robustly? What about anatomy changes? How can we take decisions (e.g., whether a plan is acceptable or not acceptable) with all the information that robust evaluation can give us? The necessity to “calibrate” robustness according to the wide clinical experience we have in photons is a take-home message that I found very useful. The journal club offered the opportunity to have a very interesting discussion on this.

The second interesting aspect was motion management and adaptive approaches. In particular, Tony Lomax presented the online adaptive workflow that is implemented at the Paul Scherrer Institut, Switzerland, and that was a very interesting proof of concept. Given all the small pieces that must be put in place in order to make it work, with a proper quality assurance of the steps while maintaining the time within clinically acceptable limits, it was really impressive from a methodological point of view.

I think it’s an interesting course for people who are beginning to deal with the proton world and gives the opportunity for very useful discussions with the faculty and the other attendees, particularly because the number of attendees is not huge.

Proton therapy is a relatively small world, so cooperation and knowledge sharing are crucial for us to do a good job.

Giacomo Reggiori

Medical physicist

IRCCS Humanitas Research Hospital

Rozzano (Milan), Italy

giacomo.reggiori@humanitas.it