Programme

Overview: The growing availability of high-quality international guidelines (e.g., European Society for Radiotherapy and Oncology, American Society of Clinical Oncology) • The persistent gap between evidence-based recommendations and real-world clinical practice • Key barriers to implementation: Resource limitations, Health system constraints, Human and organizational factors • Global disparities in radiotherapy access and infrastructure • The importance of resource-adapted guidelines for different healthcare settings • The emerging role of implementation science, digital tools, and AI in improving adherence • A proposed multi-level implementation model (global → national → institutional) • The need for stronger involvement of international societies in supporting implementation • Key message: Guidelines should be evaluated based on patient benefit, not publication impact

Overview: This session will explore what “good enough” means in modern radiotherapy, spanning technological uncertainties, clinical and radiobiological evidence generation and daily clinical practice. It will examine how advances in imaging, planning and treatment delivery may reduce some uncertainties while redistributing others, and why margins or probabilistic approaches in treatment planning will remain essential to ensure reliable dose delivery. It will highlight the importance of accurate and robust predictive models for “good enough” treatments and how patient-centred goals can guide safe, timely and meaningful care. Finally, the session will address the persistent gap between evidence, access and innovation.

Overview: Radiotherapy quality assurance is not a bureaucratic checkbox — it is a scientific necessity. Any clinical trial with a radiotherapy component stands or falls on the rigour of its RTQA. This joint ESTRO-EORTC symposium makes that case compellingly, exploring why RTQA must be embedded in all trials, how protocols can be harmonised globally, and how value assessment frameworks can strengthen the evidence base for radiotherapy. Drawing on decades of trial experience, the session offers both the rationale and the practical tools to raise the bar in radiotherapy trial design.

Overview: This interdisciplinary pitch session will examine the key barriers preventing biologically guided radiotherapy from moving from concept to routine clinical implementation. Starting from the clinical rationale for biologically guided dose prescription, speakers will address the current evidence, the limitations imposed by tumour and normal tissue biology, and the regulatory and practical challenges of clinical implementation. The session will then explore the role of biomarkers in biologically guided radiotherapy, with particular focus on imaging biomarkers, including their definitions, the most promising and clinically feasible candidates, and the key translational challenges related to biological validation, technical validation, and standardisation across centres. Further discussion will focus on the difficulties in defining the CTV, especially for nodal CTV-N for head and neck cancer and on the relative patient’s individual risk estimation. Finally on the RTT perspective, highlighting workflow, QA, training, infrastructure, and multidisciplinary coordination needed to make biologically guided radiotherapy clinically actionable.