ESTRO 2021 Abstract Book
Teaching lecture: New developments In skin cancers treatment: is brachytherapy the new frontier especially for the face?
SP-0011 New developments In skin cancers treatment: is brachytherapy the new frontier especially for the face? P. Wojcieszek 1 1 The Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Brachytherapy Department, Gliwice, Poland Abstract Text Interest in the basal cell cancer (BCC) alternative methods of treatment grow in the recent decade. While surgical procedures remain the primary method to cure BCC, there is a great need to treat patients refusing or incapable of undergoing the tumour's incision. The increasing age of society, the growing number of new cases per annum, or the risk of non-radical surgical margins, especially in the high-risk areas and the need for good cosmetic results, encourage new alternatives in BCC management. Surface Brachytherapy has a long history in the efficient management of BCC. Over the years, different applicators have been developed, which are now commercially available. Many centres use individual moulds, and some of them move to three-dimensional printing. Additionally, brachytherapy itself has evolved. High- dose-rate brachytherapy combined with computed tomography imaging and computer-based 3D planning deliver a highly conformal dose, which means optimal coverage of the target volumes with prescribed dose and, simultaneously, organs-at-risk preservation. It is based not only on precise iridium source dwell times and positioning but also on the computer algorithm optimization of isodoses. A combination of these features brings treatment tool capable of being patient individualized and selected to fit the needs of the medical staff and the patients. Modern treatment needs modern measures. The face area has tremendous significance for humans. The choice of a suitable approach is essential for the quality of life of our patients. The state-of-the-art high-dose- rate brachytherapy is in the vanguard of individualized skin cancer treatment, especially in the face. Abstract Text Core or global curricula are common entities across medical specialities. Although such texts are common, a universal understanding of their purpose is unclear. Global curricula can be conceptualized as a text, which intends to use a common vocabulary and shared philosophy, and which describes an outcome, including competency items, that are intended to be applicable across nations. The ESTRO Core Curriculum is one such text. It is now in its 4th edition and has seen advances in each edition in both the representation of perspectives in the development and endorsement of the text as well as the comprehensiveness of the content. The creation of global curricula is motivated by many factors but most commonly to define specialty specific standards, to harmonize training standards, and/or to improve the quality of training. Such curricula also face a number of challenges which include intercountry variation such as differences in the healthcare system, the operationalization of medical training and socio-cultural differences and the need for a multi- stakeholder approach. These challenges undoubtedly impact the uptake and implementation of the curricula and can only be addressed by explicit efforts. The first European Core Curriculum on Radiotherapy was published in 1991. Despite the enduring nature of the curricula, little is known about its implementation. Exploration of the current landscape for implementation of the curricula is needed. We conducted an international, cross- sectional survey study of the 29 national societies who endorsed the 4th Edition. The purpose was to report the perceived factors that impact the implementation of the ESTRO Core Curriculum from the perspective of the National Oncology Societies. This work identified that the content and values espoused in the ESTRO Core Curriculum are endorsed across diverse geopolitical regions. However, barriers to curricular implementation are identified at the organizational and systems level and include insufficient teaching faculty, lack of coordination and the need for influential leadership. These data demonstrated that in an organization that has progressively increased the geopolitical diversity of representation in their efforts to revise their core curriculum they have achieved support for the content and values which they cover in the curriculum. In this presentation we will applying an anti-colonial lens to the work on global curricula in oncology. An anti-colonial approach allows us to explore taken-for-granted norms and beliefs of a dominant culture and how individuals perspectives may be excluded who are not part of this dominant group. It also allows exploration of the power relationship configurations embedded in ideas, cultures and histories of knowledge production and use. In medical education, neocolonialism is conceptualized as practices of exporting Western concepts and pedagogical methods without consideration of power relations. There is implicit tension between global or core standards, including the generation and setting of global or core competencies, with educational ideals oriented to respecting local diversity and local historical educational practices. Applying these theories to the implementation of the ESTRO Core Curriculum allows us to reflect on the process by which consensus is achieved and the potential impact on factors which may be critical for implementation. Symposium: Education in radiation oncology SP-0012 ESTRO Curricula done and published - Now what? M. Giuliani 1,2 1 Princess Margaret Cancer Centre, Radiation medicine program, Toronto, Canada; 2 University of Toronto, Department of Radiation Oncology, Toronto, Canada
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