Value driven Adaptation in Radiation Oncology

 

Chairs: 

• Richard Canters, Medical Physicist, Maastro Clinic, Maastricht (NL)

• Lone Hoffmann, Medical Physicist, Aarhus University Hospital, Aarhus (DK)

• Ditte Sloth Møller, Medical Physicist, Aarhus University Hospital, Aarhus (DK)

Invited speakers: 

To be confirmed

 

Motivation:

Treatment adaptation, either online or offline, is a subject that the RO community puts much effort into, both financially and in terms of personnel. As an addition to this effort, we propose to use more quantitative tools such as dose-based metrics or TCP/NTCP models to evaluate the need for adaptation and the expected clinical benefit of adaptation, both on a cohort basis as well as on a patient during his/her treatment. To achieve this, existing tools such as reliable dose summation, TCP/NTCP models can be combined.

A few weeks before the workshop there will be a pre-meeting. Each participant will present some slides about their work in the field of adaptative radiotherapy. Additionally, every participants will bring a clinical case.

In this workshop, we will address these topics in the following sessions. Each session will contain of a short presentation after which we will take time for discussion and exchange:

How to use TCP and NTCP models to generate quantitative criteria and guidelines for adaptation

How can  TCP and NTCP be used in decision making, and how can we generate quantitative criteria. Which data needed for models, what models are there, how do we make them? Do we need dose accumulation, and how do we incorporate this?

Risks: margins/intrafraction motion/accumulation/delineation Deformable dose accumulation

What uncertainties are there, what could we be missing? Based on clinical cases, risks will be discussed.

Costs of adaptation

What are the costs of adaptation, in terms of personnel, equipment, and how do we compare this to the clinical benefits.

Comparing: online vs offline adaptation: which to choose

Online and offline adaptation have their strengths and weaknesses, per tumor site. Which type of adaptation should we choose and how to determine this?

What do we need from the vendors

Many tools are available from the vendors. What do we need as physics community to ensure quality and improve workflow?

The workshop will bring together physicists who are actively involved in ART in clinical a setting and representatives from vendors to actively discuss the challenges and opportunities in value driven ART.

 

Potential outcomes:

With this workshop, we aim to reach the following goals:

• Generate a practice change in the application of ART, possibly through the creation of a consensus paper about implementation of ART in a value based manner
• Collaboration in a working group e.g. on the creation of especially TCP models through retrospective and prospective studies.