Programme

Overview: This session will explore the complex role of senescent cells in shaping therapeutic efficacy and long-term consequences. Speakers will provide a comprehensive exploration of radiation-induced senescence across diverse biological contexts. We will examine how radiation-induced senescence in stromal fibroblasts contributes to tumor growth, recurrence, and therapy resistance, driven by the senescence-associated secretory phenotype (SASP). Moreover, the role of radiation-induced senescent cells in the tumor microenvironment of glioblastomas will be presented. Additionally, speakers will delve into the heterogeneity of senescence signatures in normal tissues, with a focus on lung endothelial cells and their role in radiation-induced fibrosis. Finally, we will discuss senescence-driven fibrosis across multiple organ systems and the potential of senolytic therapies to mitigate these effects.

Overview: This joint ESTRO-ESMO session, chaired by Matthias Guckenberger, Giuseppe Curigliano and Barbara Jereczek-Fossa, will explore how radiation therapy and modern systemic treatments can be better integrated in precision oncology. International experts including Icro Meattini, Sean O'Cathail, Esmee Lauren Looman and Bharti Devnani will discuss SBRT-drug combinations, evidence generation, and innovative tools such as living systematic reviews and computational modelling. Together, these efforts are driving the future of multidisciplinary precision cancer care.

Overview: This session explores the clinical impact of AI in radiotherapy workflows to date. Presentations will cover the use of AI in image segmentation and treatment planning, highlighting improvements in efficiency, consistency, and precision. In addition, the potential and current bottlenecks of AI in supporting clinical decision-making will be discussed. Finally, insights from the ARCHERY trial will demonstrate how large-scale evaluation can advance the global implementation of AI. Together, these talks provide a comprehensive overview of what AI has brought to clinical practice so far and what lies ahead.

Overview: The choice of physical quantity for dose reporting in radiotherapy is crucial: it must correlate with clinical outcomes, be easily communicated to support consistent practice, and be accurately calculated or measured. Traditionally, dose to water fulfilled this role, as radiation doses were derived from measurements in water. However, modern dose calculation methods—such as Monte Carlo algorithms, linear Boltzmann solvers, and convolution/superposition techniques—now allow different dose definitions, creating uncertainty. This session will review recent recommendations clarifying these definitions, explain their historical context, discuss remaining challenges, and address quality assurance requirements for the reported dose quantity.

Overview: This interdisciplinary symposium brings together clinical, technical, and research perspectives to examine the evolving role of CBCT‑-based dose calculations in adaptive radiotherapy (ART). It opens by outlining the key assumptions and uncertainties of CBCT‑-based dose computation and places them in context with the uncertainties already accepted in conventional planning. The session will then discuss three perspectives from different radiotherapy centres that have implemented, or are actively developing, CBCT-based recalculation workflows and CBCT-based adaptive planning. The first perspective reviews the transition from traditional TLP utilisation to CBCT‑-based dose assessment and examines how responsibilities are distributed within offline ART workflows. A head and neck workflow example illustrates how multidisciplinary roles (particularly RTT involvement) may evolve and where practical limitations remain. A second centre-based perspective introduces continuous, automated dose monitoring for patient specific quality assurance (PSQA). Using a lung dataset, it compares anatomical reporting with automated dose‑-based triggers, highlighting how numerical monitoring can reveal underreported changes and support scalable automation amid staffing pressures. The final presentation shares experience with trigger‑-based offline ART, discussing workflow development, patient‑-selection strategies, and the ongoing need for clearer criteria. Despite challenges, evidence shows that offline ART can deliver meaningful clinical benefit while underscoring the continued need for development in this area.