Programme

Overview: This session will explore the complex interplay between radiotherapy (RT) and the tumor microenvironment (TME), focusing on stromal-mediated immunosuppression, metabolic rewiring, and immune escape mechanisms. Key topics include the role of cancer-associated fibroblasts (CAFs), tumor associated macrophages (TAMs) and tumor infiltrating lymphocytes (TILs) in promoting radio-sensitivity vs resistance, the impact of RT on the tumor stroma, TME reshaping by low-dose RT (LDRT), and strategies to enhance radio-immunotherapy synergy including by targeting metabolic enzymes. Additionally, speakers will explore the role of hypoxia, particularly in glioblastoma, and of dysregulated purinergic signaling in radiation-induced immune escape.

Overview: This session will address how carrying BRCA mutations may effect reproductive potential, fertility preservation strategies, and the safety of pregnancy. It will address risk reducing surgery and delve into how loco-regional therapy for those diagnosed with breast cancer may be individualised. Factors influencing surgery and the benefits and risks of breast conservation versus mastectomy will be presented taking into account oncological outcomes, genetic risk factors and patient preferences. Decision-making around adjuvant radiotherapy will be discussed including how novel systemic therapies may modify the radiotherapy landscape. Importantly this symposium will include the patient voice to better understand what is most important to young BRCA carriers in terms of treatment goals and unmet needs.

Overview: Over the last 5 years there have been many practice changing developments in the management of endometrial carcinoma. The role of molecular markers, their impact on risk estimation and treatment decisions has evolved. Therefore, the FIGO staging system has been revised in 2023 to include molecular markers. In 2025, the ESGO-ESTRO-ESP guidelines on the management of endometrial carcinoma have been updated according to the latest evidence.

Overview: This symposium will focus on AI and machine learning applications for MRI-guided radiotherapy. Anaïs Barateau will introduce the integration of AI in MRI-guided Radiotherapy (MRIgRT), discussing algorithm basics, some examples and future challenges. Luise Anna Künzel will provide a comprehensive overview of the MRIgRT workflow, emphasizing the current role of AI in various stages including the possibilities for full automation of the workflow. Guillaume Landry will explore motion management in radiotherapy workflows, highlighting the TrackRAD2025 Challenge for real-time lesion tracking. Finally, Davide Cusumano will present findings from the MESCAL project, evaluating synthetic CT algorithms for MRI-only Radiotherapy. Join us for an in-depth exploration of these cutting-edge topics.

Overview: In this debate 4 renowned clinical physicists will debate whether or not we still need a routine patient/plan specific quality assurance (PSQA) measurements. With the introduction of complex radiotherapy techniques like IMRT, VMAT and stereotactic radiotherapy in the beginning of this century and uncertainties associated with small field dosimetry, MLC modelling in TPS, etc. have increased the demand for PSQA. The provision of commercial PSQA tools lead to intensification of PSQA. PSQA has certainly increased our quality and safety of complex radiotherapy techniques. Over the years, radiotherapy delivery machines have become more stable. Also, treatment planning dose calculations have become more accurate. Moreover, data transfer is exceedingly automated, reducing the chance on human errors. As such, it seems the treatment delivery process might be “in control”. This would mean that, if the treatment techniques are properly commissioned, measurement based PSQA would become less important. Is this true? Come to this debate and let your opinion count! Arguments for and against continued measurement based PSQA will be shared and you can vote who has won the debate.

Overview: Positioning and immobilisation are fundamental steps in the RT patient pathway, uniquely vital for ensuring treatment reproducibility and precision. RTT experts will argue for and against the proposition considering traditional immobilisation strategies in light of advancements such as Surface-Guided Radiotherapy (SGRT), particle therapy, and online ART. Proponents argue that modern technologies and techniques reduce reliance on rigid immobilisation, enhancing patient comfort and experience. Opponents caution against abandoning these proven methods, emphasizing the risks of excess external and internal motion and misalignment without robust positioning systems. Join this engaging session as we discuss the evolving role of immobilisation in RT and its implications for patient care and daily practice.

Overview: The teaching lecture will provide an overview of the main techniques used for image guidance in radiotherapy and the recent developments in this field. The lecture will focus on the most central in-room imaging modalities, including x-ray, MRI and surface guided radiotherapy (SGRT). For each of these the lecture will cover their use in patient setup, motion management and potential for adaptive radiotherapy. The presentation will mainly be relevant for photon therapy, but will give some examples on differences and similarities of the use of these techniques also in proton therapy. Perspective on emerging image guidance methods will be briefly discussed.

Overview: In this session we welcome our two multidisciplinary speakers from The Catharina Cancer Institute in Eindhoven, The Netherlands. During this session we will have the opportunity to learn first-hand how deep learning segmentation (DLS) has been implemented in their clinic, and how this process has changed their practice. Firstly, Clinical Physicist, Coen Hurkmans, will consider the motivation to implement DLS practices in a clinical environment. Drawing on evidence from the literature, he will highlight achievable results, common pitfalls, and strategies to mitigate errors in segmentation. He will also provide us with a comprehensive guide to evaluating the quality of segmentations within clinical workflows. Coen will also address the how to establish a multidisciplinary team to support the implementation phase of DLS. His talk will then be followed up by RTT colleague, Melissa Verdonk-van den Heuvel. Melissa will talk us through the practicalities of introducing DLS, using examples from various imaging technologies, including CBCT and MRI. She will also highlight the outcomes of testing protocols, and the ongoing quality assurance measures in place critical to the success of DLS. Finally, Melissa will discuss the evolving roles of radiation therapists (RTTs) in this changing landscape and explore potential future opportunities for advanced practice.

Overview: Reading literature related to radiation oncology is crucial for researchers and clinicians, yet peer review alone doesn’t guarantee quality. This session will equip young professionals with essential skills to critically evaluate such studies. Participants will learn practical techniques to assess methodologies, analyze findings, and determine the relevance of research to clinical or professional practice. By exploring examples like clinical trials and studies using artificial intelligence and machine learning, attendees will learn to read with both clinical and reviewer perspectives, avoid common pitfalls, and contribute actively to scientific dialogue, fostering informed engagement with evolving research methodologies.