Abstract Book

S338

ESTRO 37

research findings happen quite quickly amendments can be introduced through regulation. In Europe legislation is governed through EU directives. These are legal instruments binding on member states in terms of their objectives. They require member states to achieve a particular result without dictating the means of achieving that result. Each member state is free to decide on how to implement the directive nationally but the principles of the directive must be maintained. Several directives are important to consider in the context of radiotherapy practice not all related to radiation safety. Council directive 89/391/EEC lays down minimum requirements for encouraging improvements in the working environment. The associated EU strategic framework on health and safety at work from 2014 to 2020 recommends methods to better protect EU workers from both work- related accidents and disease, identifying key challenges and strategic objectives for worker health and safety. Key actions and instruments to address these key actions are identified to achieve continuous improvement. Council directive 90/269 relates to the manual handling of loads and is a framework to avoid or reduce the risk of injury resulting from manual handling activities. The aim of this is the avoidance or reduction of the need for manual handling, particularly with the relation to back injury. It suggests the use of mechanical devices that may avoid or reduce the need of manual handling. Council directive 90/270 relates to display screen equipment. All workstations must be evaluated in respect of the risks to eyesight, the physical problems related to positioning of equipment and seating and potential mental stress from viewing multiple computer screens. Measures should be taken to resolve any problems detected. The legislation governing radiation protection is enshrined in the EURATOM treaty signed on the 25th March, 1957. The EURATOM Treaty defined the community role in promoting research and disseminating technical information. It also aimed to establish uniform safety standards to protect the health of workers and the general public and to ensure that they are applied effectively within each member state. There are three individual pieces of legislation under EURATOM to consider: · The Radiological Protection Act of 1991 establishing The Regulatory Authority responsible for authorizing the possession and use of radiation sources in radiotherapy by license without exclusions or exemptions from regulatory requirements. · The Basic Safety Standards, revised in 2012, is a framework directive on the protection of the public and exposed workers against the dangers of ionizing radiation. It covers aspects of practice, intervention and work activity. · 2013/59/EURATOM relating directly to the patient or the individual undergoing a planned medical exposure. Legislation in the area of radiation protection was first introduced in directive 90/641/EURATOM which has now been repealed by directive 2013/59/EURATOM published in January 2014. This directive enshrines more specific elements of radiotherapy than previous directives, including a legal obligation to report and learn from accidents and incidents. Another piece of legislation that is relevant to radiotherapy is Directive 2001/20/EC which relates to radiotherapy clinical trials and imposes for the first time in European law specific protection for healthy individuals and patients participating in medical and biomedical research involving radiation. This is also reflected in the BSS. So how does all this legislation actually impact on our every day practice? It is quite clear that both employers and employees have a responsibility to know and comply with current legislation as it pertains to health and safety with failure to do so resulting in potential litigation. This requirement to be familiar with current legislation and how it evolves is incorporated into the employers’ duty of care. Employees also have a duty of care with respect to how they carry out their daily work. They have a

responsibility to report any defects, near misses, incidents or anything they consider to constitute unsafe practices. What is important to remember is that this employer and employee duty of care imposes an absolute duty of care. That means that any breach of duty of care can actually be liable to individual criminal pro- ceedings.

Teaching Lecture: Normal tissue stem cells and cancer stem cells in radiation response

SP-0636 Normal tissue stem cells and cancer stem cells in radiation response R. Coppes 1 1 Radiation Oncology and Cell Biology, Department of Radiation Oncology and cell Biology- FB30, Groningen, The Netherlands Abstract text Stem cells play a pivotal role in the response to radiotherapy. The response of normal tissues to irradiation is mainly determined by the survival and regenerative potential of the tissue stem cells. Similarly, stem cells play a pivotal role in the response to radiotherapy since for the tumour these are the target cells that ultimately determine treatment outcome. Therefore, exciting new avenues for development of stem cell-based therapies for regeneration of tissues or treatment of cancers have been opened in the field of stem cell research. Transplantation of tissue specific stem cells has been shown to restores tissue homeostasis and prevent late radiation effects. Moreover, the sparing of localized stem cells may preserve tissue functioning after radiation therapy. In contrast mounting evidence indicates that cancer stem cells might contribute to the poor prospects. Therefore, the current challenge in radiation oncology is to specifically target the cancer stem cell while sparing the normal tissue stem cells. This lecture will discuss the characteristic of the different stem cells, their related radiosenstivity and potential future therapeutic approaches for personalized optimisation of (chemo-) radiation treatment and prediction of treatment response.

Teaching Lecture: Hypofractionated external beam radiotherapy for Prostate cancer: what have we learned in the last 15 years?

SP-0637 Hypofractionated external beam radiotherapy for Prostate cancer: what have we learned in the last 15 years? A.Bossi Institut Gustave Roussy, Villejuif, France

Abstract not received