Programme

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.

Overview: The integration of immunotherapy into perioperative management of head and neck cancer presents both new opportunities and challenges. Key surgical issues include optimal timing of neoadjuvant therapy and accurate assessment of residual disease. For the radiation oncologist, safe combination of immunotherapy with radiotherapy in the adjuvant setting, particularly regarding toxicity and synergy remain a concern. Defining pathological response and its prognostic value while developing reliable predictive and dynamic biomarkers will be critical to guide patient selection and advance personalized treatment in this evolving field.

Overview: It has been, for many years, the aim of many medical physicists in our field to ensure precision of our treatments. Delineation, treatment planning, image guidance, machine QA, plan QA all seem to aim for the highest precision achievable. Indeed, in recent years, the precision of our treatments has become excellent. However, still, a lot of effort is spent improving or maintaining this precision. Simultaneously, healthcare costs are rising, our workforce is under pressure and we can only spent our time once. Is it still worthwhile to spent resources in trying to improve the precision of our treatments, or have we reached a plateau where ‘good’ is actually ‘good enough’? Should we continue to pursue the highest precision, or is it enough to be “as precise as reasonably achievable”?

Overview: This symposium explores how different aspects of radiotherapy practice contribute to improving the patient experience. It highlights the role of RTT-led research in understanding what matters most to patients. The development of clinical academic career pathways is discussed, showing how RTTs can combine clinical work and research to directly improve care. Patient engagement is another key focus, demonstrating how continuity and supportive interactions with RTTs positively influence patient experience and satisfaction. Finally, the symposium examines how technological innovations, such as AI and adaptive radiotherapy, can support patient-centred care when guided by patient needs, multidisciplinary collaboration, and a focus on meaningful outcomes.