Programme

Overview: This symposium explores dualities that emerge between different optimization approaches in radiotherapy, and efficiency, consistency, quality, and limited resources. Four speakers, from different professional groups and environments, will promote ideas of how to optimize healthcare based on architectural design (process- and staff-focused) and show how inclusion of a robust scheduling approach balances “flowtime” (preparation time including intake) and risk of delays. In addition, the challenges of patient-centred care and models of care will be discussed and strategies will be outlined to drive innovation despite lack of resources.

Overview: In this fierce debate, experienced colleagues will explain us whether the level-1 evidence demonstrated effects of regional nodal irradiation (RNI) in decreasing relapses and improving survival for breast cancer patients continue outweighing possible late toxicity in the present era of more effective systemic therapies. We will be asked how we can identify the specific internal mammary (IM) irradiation benefit as component of RNI? What is the impact of more individualised RNI techniques, on both efficacy and toxicity, especially in view of contemporary systemic agents? How can we fit individualisation of indications, prescriptions, and techniques in the ongoing trend of decreasing surgical extent? So, let you take away by the debaters, absorb and process all information and finally decide and vote for yourself whether you agree or not with the statement that IM irradiation should be standard of care for high-risk breast cancer patients!

Overview: The dosimetry code of practice TRS-483, jointly produced by the IAEA and AAPM in 2017, provided essential guidance on the choice of detectors and methodologies in the determination of dose in small static MV photon fields. Dose determination under more complex irradiation geometries are yet to be addressed. Further to this, recent technological developments utilising narrow collimated fields delivered at dose rates higher than the conventional, pose additional challenges. This symposium aims to provide insight and present current efforts to address these. FLASH radiotherapy has recently gained major interest. Commercial systems are becoming available for clinical use and clinical trials are commencing for both electron and proton therapy. FLASH brings unique challenges to dosimetry, beam control, and verification. The dosimetric issues specific to FLASH and methods and detectors capable of operating under high dose rate conditions will be reviewed.

Overview: Late effects are a critical concern in radiation therapy but can be challenging to assess due to the long latency period between treatment and develop. This session will discuss dose reconstruction of prior treatments, imaging biomarkers for early prediction of late effects, and ways to refine and improve our models going forward to maximize their accuracy and clinical utility.

Overview: IGRT and motion management strategies are an important part of imaging procedures. In this session the newest ESTRO ACROP guideline recommendations regarding set-up and position verification will be presented in relation to breast cancer imaging. Thereafter the different approaches for breathing motion management are discussed as their pros and cons. In the case of complex stereotactic treatments an IGRT strategy cannot be lacking. This will be clarified in combination with the use of SGRT and in cases of adaptive therapy.

Overview: Mini-Orals are presented at one of the sessions scheduled in the two mini-oral theatres. Each author will present a 4-slide PowerPoint orally for 4 minutes, followed by 3 minutes for discussion. Sessions will not be recorded.

Overview: Mini-Orals are presented at one of the sessions scheduled in the two mini-oral theatres. Each author will present a 4-slide PowerPoint orally for 4 minutes, followed by 3 minutes for discussion. Sessions will not be recorded.

Overview: Poster Discussions are presented in one of the sessions scheduled at the two poster discussion theatres. Each author will present a digital poster orally for 2 minutes, followed by 2 minutes for discussion. Sessions will not be recorded.

Overview: Poster Discussions are presented in one of the sessions scheduled at the two poster discussion theatres. Each author will present a digital poster orally for 2 minutes, followed by 2 minutes for discussion. Sessions will not be recorded.