Lisbon, Portugal

Image guided radiotherapy and chemotherapy in gynaecological cancer: focus on MRI based adaptive brachytherapy for Cervical Cancer

This course provides understanding of the rationale for advanced image guided external beam and brachytherapy techniques in gynaecological cancer. With this course you will learn tools to update and change clinical practice in your institution.

The course is aimed at radiation and gynaecology oncologists, medical physicists and radiation therapists (RTTs) involved in gynaecological tumour treatments, interested in the implementation of EBRT and brachytherapy image guidance. Course participants should have specific interest in and/or initial experience with implementation of advanced MRI based brachytherapy and advanced EBRT techniques (IMRT/IGRT).

The course aims to: 

  • Teach about principles of 3D image-based EBRT and brachytherapy including techniques and treatment planning in gynaecological cancer
  • Provide understanding of commissioning, quality assurance, principles of planning, plan evaluation and reporting of 2D and 3D brachytherapy with focus on cervical cancer
  • Introduce 3D image-based (adaptive) target concepts of GTV, CTV and PTV including both EBRT and brachytherapy with focus on cervical cancer
  • Enable practical implementation of 3D techniques in EBRT and brachytherapy with focus on cervical cancer
  • Provide an overview on radiation therapy (external radiation and brachytherapy) and clinical outcome in gynaecological cancers.
  • Enhance the practical implemention and logistics for transition to 3D/4D in the existing environment.
  • Provide further roadmap and steps of intervention to improve the existing standards


By the end of this course participants should be able to:

  • Understand the rationale of 3D and apply concepts of advanced brachytherapy techniques in clinical practice
  • Perform contouring and treatment planning for 3D image guided EBRT and brachytherapy in clinical practice
  • Implement procedures for 3D image guided brachytherapy focussed on cervical cancer in own department
  • Implement advanced EBRT techniques in cervical cancer in own department.
  • Give feedback and review of hurdles in implementation



  • Normal, pathologic anatomy and clinical examination of female pelvis 
  • Image based anatomy including US, CT, MRI and conventional radiography
  • CTV/ITV/PTV for external irradiation
  • Combination of external irradiation and brachytherapy
  • Different application techniques in brachytherapy
  • Commissioning and Quality Assurance of various processes involved in 3D treatment planning.
  • Application techniques in brachytherapy including combined intracavitary-interstitial applicators
  • Treatment planning for brachytherapy
  • ICRU 89 concepts: GTV, CTV, PTV at diagnosis and at time of brachytherapy for 2D and 3D brachytherapy (adaptive target concept)
  • Dose, dose-rate and fractionation and overall treatment time
  • Radiobiological effects from combined external irradiation and brachytherapy, linear quadratic model
  • Prescribing, recording and reporting including ICRU 89 - GEC-ESTRO recommendations and ESGO/ESTRO/ESP guidelines for the management of patients with cervical cancer
  • Therapeutic outcome: radio-chemotherapy, image based EBRT and brachytherapy including EMBRACE
  • Reflexion of participants` clinical experience in image guided radiotherapy (experienced track)
  • Two different tracks will be offered which are adapted to different levels of clinical experience among participants: “General track” and “Experienced track”. The major part of the programme will be joint sessions, while break-out sessions for the two tracks will amount to a total of 5.5 hours distributed on day 2, day 3 and day 4. “Experienced track” can maximum accommodate 20 participants.
  • The "General track" has a more elaborate educational component and will include all introductory lectures into image guided brachytherapy such as brachytherapy techniques, target contouring, and ICRU 89 - GEC-ESTRO recommendations.

    The “Experienced track” will feature break-out sessions where each participant (or optimally a team of MD and physicist/RTT from one department) present a patient case on power point (diagnostic work-up, EBRT target contouring and treatment planning as well as brachytherapy application, target contouring and treatment). Templates for case presentations will be available and these should be used to prepare a 15 minutes presentation of the case. The break-out sessions will be supervised by faculty members (MDs and physicists), so that individual feed-back on treatment practice can be obtained.


    Depending whether you opt for the general or experienced track, slightly different prerequisites will apply. These are detailed above[RP1] .



    Description: The tutorials include discussions of basics, evidence based treatments, contouring guidelines, various processes involved in advanced EBRT and brachytherapy techniques and quality assurance. The practical hands on demonstration covers a direct learning process involved in approach, brachytherapy techniques, contouring exercises, evaluation and discussions on 3D radiotherapy.



  • Lectures: 16 hours
  • Applicators commissioning and reconstruction: 6 hours - Physicists

  •  [RP1]I do not see any detailed description further upwards.Contouring (FALCON tool) and dose planning exercises (pre- and post-course homework)  Interactive feedback through audience voting on specific questions during lectures MCQ (interactive session at the end of the course) ESTRO teaching course evaluation form  Exclusive feedback sessions for “Experienced track” participants



    Evidence based multi-modality management guidelines 2D to 3D transition 3D Image Guided Adaptive Brachytherapy (IGABT) in cervical cancer
    • Contouring guidelines for advanced EBRT including IMRT/ IGRT and image based brachytherapy with focus on cervical cancer



    Will be specified under Learning Objectives (available for participants after registration on ESTRO Moodle)



    Application for CME recognition will be submitted to the European Accreditation Council for Continuing Medical Education (EACCME), an institution of the European Union of Medical Specialists (UEMS). EACCME credits are recognised by the American Medical Association towards the Physician’s Recognition Award (PRA). Information on the status of the applications can be obtained from the ESTRO office.

  • Practical workshops: 8 hours
  • Video presentations by faculty???: 2-3 hours – Clinician Pre-course questionnaire
  • Registration sheet for decision on general track versus experienced track


Programme to follow

Key Words

External beam radiotherapy (EBRT) and 3D Image Guided Adaptive Brachytherapy (IGABT) in cervical cancers, contouring guidelines for advanced EBRT including IMRT/ IGRT and image-based brachytherapy in cervical cancer.

Course Directors

  • Remi Nout, Radiation Oncologist, Erasmus Medical Center, Rotterdam (NL) 
  • Kari Tanderup, Medical Physicist, University Hospital, Aarhus (DK)


  • Simon Duke, Radiation Oncologist/PhD Student, Addenbrooke´s Hospital- Oncology Centre, Cambridge (UK)
  • Ina Jürgenliemk-Schulz, Radiation Oncologist, University Medical Centre, Utrecht (NL) 
  • Umesh Mahantshetty, Radiation Oncologist, Tata Memorial Hospital, Mumbai (IN)      
  • Nicole Nesvacil, Medical Physicist, Medical University Hospital, Vienna (AT) 
  • Primoz Petric, Radiation Oncologist, Aarhus University Hospital (DK)      
  • Richard Pötter, Radiation Oncologist, Medical University Hospital, Vienna (AT)              
  • Monica Serban, Medical Physicist, McGill University Health Centre, Montreal (CA)
  • Li Tee Tan, Radiation Oncologist, Addenbrooke’s Hospital - Oncology Centre, Cambridge (UK)


To follow


ESTRO members can order products at substantially reduced prices. Please note that in order to benefit from the member price, you must renew your membership for 2022 before registering to the course.To benefit from these member rates, please visit the membership page to become a member or renew your membership BEFORE proceeding with your order.



Early rate

Late rate

In-training members*

  450 EUR

 625 EUR


  600 EUR 

 725 EUR

Non Members

  750 EUR

 850 EUR

* Members with specialty RadiationTherapist (RTT) may register at the In Training fee

Early rates are applied up to three months before the starting date of the course.

Late rates are applied three months before the starting date of the course.

The fee includes the course material, coffees, lunches, and the social event.

Advance registration & payment are required.

Since the number of participants is limited, late registrants are advised to contact the ESTRO office before payment, to inquire about availability of places. Access to homework and/or course material will become available upon receipt of full payment.

Insurance and cancellation

The organiser does not accept liability for individual medical, travel or personal insurance. Participants are strongly advised to take out their own personal insurance policies.   

In case an unforeseen event would force ESTRO to cancel the meeting, the Society will reimburse the participants fully the registration fees. ESTRO will not be responsible for the refund of travel and accommodation costs.

In case of cancellation, full refund of the registration fee minus 15% for administrative costs may be obtained up to three months before the course and 50% of the fee up to one month before the course. No refund will be made if the cancellation request is postmarked less than one month before the start of the course.

Reduced fees

Members from emerging countries may register at a preferential rate of 350 Euro. Emerging country fee applies to individuals from low-income and lower-middle-income economies according to the World Bank listing here.

Additionally, all specialties from the following countries can benefit from this preferential rate: Albania, Belarus, Bosnia and Herzegovina, Bulgaria, Croatia, Czech Republic, Estonia, Greece, Hungary, Latvia, Lithuania, Macedonia, Moldova, Montenegro, Poland, Portugal, Romania, Russian Federation, Serbia, Slovak Republic, Slovenia, Spain, Turkey, Ukraine.  In addition, medical physicists from Cyprus can email to apply for this fee.

The preferential rate of 350 Euro is granted automatically when you click on the  BOOK NOW  button and the three conditions below are met:

  1. Only ESTRO members for 2022 are eligible (please make sure your 2022 membership is in order before you click on the BOOK NOW  button)
  2. Only one course per person per year can be subsidized by ESTRO
  3. Sponsored candidates are not entitled to reduced fees (the invoicing address has to be the one of the participant)  

 Please note:

  • We can only guarantee a certain number of reduced fees per course
  • Application deadlines are the same as early registration fees (3 months before the course date).