ESTRO 2022 - Abstract Book

Learningfrom EveryPatient 6-10May2022 ONSITEINCOPENHAGEN&ONLINE

Radiotherapy &Oncology Journal of the European SocieTy for Radiotherapy and Oncology

Volume 170 Supplement 1 (2022)

Radiotherapy & Oncology is available online: For ESTRO members: http://www.thegreenjournal.com For institutional libraries: http://www.sciencedirect.com

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6-10 May 2022 ONSITE IN COPENHAGEN & ONLINE

Table of contents

SATURDAY 7 MAY 2022

Teaching lecture Developing a national infrastructure for proton beam therapy trials...................................................................... (abs. 1) The radiobiological clock in 2022............................................................................................................................. (abs. 2 - 3) Stereotactic radiotherapy in lung: Recent advances................................................................................................... (abs. 4) Palliative radiotherapy: Established standards and emerging concepts.................................................................. (abs. 5) Improving radiotherapy outcomes for vaginal tumours using a joint target concept............................................ (abs. 6) Commissioning and quality assurance of commercial in vivo dosimetry systems.................................................. (abs. 7) Monte Carlo dose calculation in modern day radiotherapy. ..................................................................................... (abs. 8) Patient education in 2022: Does the patient know better?........................................................................................ (abs. 9) Symposium Education in radiation oncology: Advances and opportunities........................................................................ (abs. 10 - 15) Debate This house believes that FLASH radiotherapy is a more promising avenue for the future of radiation oncology than particle radiotherapy...................................................................... (abs. 16 - 21) Symposium New developments in the treatment of oesophageal cancer........................................................................... (abs. 22 - 24) All the hassle with haematopoietic systems....................................................................................................... (abs. 25 - 28) Debate Soft tissue sarcoma: Brachytherapy and/or EBRT or IORT - Current evidence............................................... (abs. 29 - 33) Joint Symposium ESTRO-EFOMP: CT innovations: DECT and beyond............................................................................................ (abs. 34 - 37) Proffered Papers Intra-fraction and real-time motion management............................................................................................. (abs. 38 - 44) Symposium Learning about the patients we do not see: A focus on inequities in radiotherapy access and provision.. (abs. 45 - 47) Mini-Oral 01: Dosimetry......................................................................................................................................................... (abs. 48 - 55) 02: Health economics & healthcare systems...................................................................................................... (abs. 56 - 63) Poster Discussion 01: Image processing & analysis.......................................................................................................................... (abs. 64 - 75) 02: Palliation, mixed sites..................................................................................................................................... (abs. 76 - 87) Proffered Papers Proton beam therapy............................................................................................................................................ (abs. 88 - 93) Normal tissue radiobiology.................................................................................................................................. (abs. 94 - 99) Late-breaking.....................................................................................................................................................(abs. 100 - 106) Upper GI.............................................................................................................................................................(abs. 107 - 112) Physics................................................................................................................................................................(abs. 113 - 118)

Dosimetry...........................................................................................................................................................(abs. 119 - 124) Photon radiotherapy planning.........................................................................................................................(abs. 125 - 130) Improving patient experience and quality standards....................................................................................(abs. 131 - 136) Mini-Oral 03: Radiobiology................................................................................................................................................(abs. 137 - 144) 04: Sarcoma, skin cancer, malignant melanoma............................................................................................(abs. 145 - 152) Poster Discussion 03: Functional imaging & modelling................................................................................................................(abs. 153 - 164) 04: Paediatrics, haematology...........................................................................................................................(abs. 165 - 176) Symposium Presidential Symposium: Learning from every patient.................................................................................(abs. 177 - 180) Joint Symposium ESTRO-ASTRO: Is integration with immunotherapy the new challenge for radiation oncologists?..........(abs. 181 - 184) Symposium Emerging radiobiological modifiers.................................................................................................................(abs. 185 - 187) Large-scale collection of PROs for clinical use during follow-up..................................................................(abs. 188 - 191) Lymphopenia.....................................................................................................................................................(abs. 192 - 195) Preserving brachytherapy skills for the future...............................................................................................(abs. 196 - 199) Joint Symposium ESTRO-AAPM: 50 shades of FLASH - From experimental beam lines to the clinic......................................(abs. 200 - 203) Symposium Automatic planning: Towards a sustainable future.......................................................................................(abs. 204 - 207) What’s new in RTT advanced practice?............................................................................................................(abs. 208 - 210) Mini-Oral 05: Image acquisition & processing.................................................................................................................(abs. 211 - 218) 06: GI...................................................................................................................................................................(abs. 219 - 226) Poster Discussion 05: Intra-fraction & real-time adaptation........................................................................................................(abs. 227 - 238) 06: CNS. ..............................................................................................................................................................(abs. 239 - 250) Award Lecture E van der Schueren Award. ..............................................................................................................................(abs. 251 - 252) Jens Overgaard Legacy Award..........................................................................................................................(abs. 253 - 254) Proffered Papers Personalised radiation therapy........................................................................................................................(abs. 255 - 260) Immuno-radiobiology. ......................................................................................................................................(abs. 261 - 266) Lower GI. ............................................................................................................................................................(abs. 267 - 272) Physics, gynaecology, prostate. .......................................................................................................................(abs. 273 - 278) FLASH..................................................................................................................................................................(abs. 279 - 284) Applications of photon treatment planning. ..................................................................................................(abs. 285 - 290) Haematology......................................................................................................................................................(abs. 291 - 296) Mini-Oral 07: Brachytherapy. ............................................................................................................................................(abs. 297 - 304) 08: Patient care, preparation, immobilisation and IGRT verification protocols..........................................(abs. 305 - 312) Poster Discussion 07: Imaging & AI techniques.............................................................................................................................(abs. 313 - 324) 08: Advances in radiotherapy planning & techniques...................................................................................(abs. 325 - 336)

SUNDAY 8 MAY 2022

Teaching Lecture MR-guided radiotherapy: How to acquire and interpret imaging data for online adaption............................... (abs. 337) Mitochondria in tumour and normal tissue radiobiology...................................................................................... (abs. 338) Breast cancer-related lymphoedema....................................................................................................................... (abs. 339) Fractionation and biology in bladder cancer........................................................................................................... (abs. 340) Artificial intelligence and brachytherapy: Current reality and perspectives. ..............................................(abs. 341 - 342) Robust treatment planning in particle therapy: Clinical implementation and potential pitfalls........................ (abs. 343) Essentials for risk management of a radiation oncology department.................................................................. (abs. 344) Less is more: The increasing use of hypofractionation in routine clinical practice and its impact on patient care. ........................................................................................................................(abs. 345 - 346) Symposium Radiation-induced cardiac and vascular toxicity............................................................................................(abs. 347 - 350) Beyond the nucleus: The role of mitochondria in radiation response. .......................................................(abs. 351 - 354) Radiotherapy in head and neck advanced disease in surgery with reconstruction area. .........................(abs. 355 - 358) 2020 - Losing ground for radiotherapy?..........................................................................................................(abs. 359 - 362) The use of imaging in prostate brachytherapy. .............................................................................................(abs. 363 - 365) Image guidance in particle therapy: Status and outlook...............................................................................(abs. 366 - 369) Pitch Session Every radiotherapy physicist should know about AI/ML... but how much?.................................................(abs. 370 - 375) Symposium Personalised radiotherapy: Improving standards of care with personalised treatments.........................(abs. 376 - 378) Mini-Oral 09: Personalised radiation therapy. ................................................................................................................(abs. 379 - 386) 10: Lung..............................................................................................................................................................(abs. 387 - 394) Poster Discussion 09: Inter-fraction motion & adaptive radiotherapy........................................................................................(abs. 395 - 406) 10: Urology 1......................................................................................................................................................(abs. 407 - 418) Proffered Papers MR-guided radiotherapy...................................................................................................................................(abs. 419 - 424) Tumour radiobiology. .......................................................................................................................................(abs. 425 - 430) Head & neck.......................................................................................................................................................(abs. 431 - 436) Lung....................................................................................................................................................................(abs. 437 - 442) Gynaecology.......................................................................................................................................................(abs. 443 - 448) Optimisation & algorithms in proton & ion radiotherapy.............................................................................(abs. 449 - 454) Radiomics & modelling. ....................................................................................................................................(abs. 455 - 460) AI & advanced practice. ....................................................................................................................................(abs. 461 - 466) Mini-Oral 11: Intra-fraction motion management. .........................................................................................................(abs. 467 - 474) 12: Head and neck.............................................................................................................................................(abs. 475 - 482) Poster Discussion 11: Radiobiology................................................................................................................................................(abs. 483 - 490) 12: GI...................................................................................................................................................................(abs. 491 - 502) Proffered Papers Highlights of Proffered Papers - Best Papers. ................................................................................................(abs. 503 - 508) Symposium Management of radio-recurrent prostate cancer..........................................................................................(abs. 509 - 512) The hypoxic tumour microenvironment.........................................................................................................(abs. 513 - 516) Joint Symposium ESTRO-EORTC: Oligometastatic Disease. ........................................................................................................(abs. 517 - 520) ESTRO-IASLC: Advances in radiotherapy for lung cancer..............................................................................(abs. 521 - 524) Symposium Ocular plaque brachytherapy. .........................................................................................................................(abs. 525 - 527)

Debate This house believes that in 10 years particle therapy will be in a better place than now!. .......................(abs. 528 - 533) Joint Symposium ESTRO-ISMRM: Quantitative MRI for radiation oncology. .............................................................................(abs. 534 - 539) Symposium RTTs: AI and digital awareness.........................................................................................................................(abs. 540 - 542) Mini-Oral 13: Implementation of new technology. .........................................................................................................(abs. 543 - 550) 14: Urology.........................................................................................................................................................(abs. 551 - 558) Poster Discussion 13: Brachytherapy. ............................................................................................................................................(abs. 559 - 570) 14: Urology 2......................................................................................................................................................(abs. 571 - 582) Award Lecture Honorary Physicist Award. ...............................................................................................................................(abs. 583 - 584) Iridium Award Lecture - in memoriam of Professor Janusz Skowronek......................................................(abs. 585 - 586) Proffered Papers Patient-reported outcomes..............................................................................................................................(abs. 587 - 592) Microenvironment.............................................................................................................................................(abs. 593 - 598) Oligometastatic disease....................................................................................................................................(abs. 599 - 604) Urology...............................................................................................................................................................(abs. 605 - 610) Prostate, head & neck, eye...............................................................................................................................(abs. 611 - 616) New technologies in clinical practice...............................................................................................................(abs. 617 - 622) Application of functional & quantitative imaging...........................................................................................(abs. 623 - 628) Breast, rectum. ..................................................................................................................................................(abs. 629 - 634) Mini-Oral 15: Treatment plan optimisation & adaptation..............................................................................................(abs. 635 - 642) 16: RTT treatment planning, OAR & target definitions. .................................................................................(abs. 643 - 650) Poster Discussion 15: Advances in patient care & treatment verifications.................................................................................(abs. 651 - 662) 16: Lung..............................................................................................................................................................(abs. 663 - 674)

MONDAY 9 MAY 2022

Teaching Lecture Rationale for microbiota-centered interventions in I-O and radiotherapy. ......................................................... (abs. 675) Modern imaging in radiation oncology...........................................................................................................(abs. 676 - 677) Biomarkers guiding dose de-escalation in HNSCC.................................................................................................. (abs. 678) U-Net for dummies..................................................................................................................................................... (abs. 679) MRI: From basic to state-of-the-art acquisition protocols...................................................................................... (abs. 680) Immobilisation in the rapidly changing world of radiotherapy: Now and into the future.................................. (abs. 681) Leadership is a journey, not a position.................................................................................................................... (abs. 682) Symposium Automation in radiotherapy.............................................................................................................................(abs. 683 - 686) Joint Debate ESTRO-PROS: This house believes that proton therapy is the standard of care for paediatric patients, adolescents and young adults requiring radiotherapy. ........................................(abs. 687 - 692) Symposium New era of personalised radiotherapy in soft tissue sarcomas...................................................................(abs. 693 - 696) Deep learning for target auto-segmentation..................................................................................................(abs. 697 - 699) Online management of target motion. ...........................................................................................................(abs. 700 - 702) Online adaptive radiotherapy: The future is near!.........................................................................................(abs. 703 - 705) The positive impact of good leadership..........................................................................................................(abs. 706 - 710) Mini-Oral 22: Mixed sites, palliation.................................................................................................................................(abs. 711 - 718) 18: CNS. ..............................................................................................................................................................(abs. 719 - 726) Poster Discussion 17: Treatment planning. ...................................................................................................................................(abs. 727 - 738) 18: Breast. ..........................................................................................................................................................(abs. 739 - 750) Proffered Papers Big data, AI. ........................................................................................................................................................(abs. 751 - 756) Paediatrics..........................................................................................................................................................(abs. 757 - 762) Pelvic malignancies. ..........................................................................................................................................(abs. 763 - 768) Deep learning for image analysis. ...................................................................................................................(abs. 769 - 774) Novel approaches towards IGRT......................................................................................................................(abs. 775 - 780) Adaptive radiotherapy. .....................................................................................................................................(abs. 781 - 786) Speed dating Grow your network. ..........................................................................................................................................(abs. 787 - 788) Mini-Oral 19: Applications of photon & ion beam therapy. ...........................................................................................(abs. 789 - 796) 20: Breast. ..........................................................................................................................................................(abs. 797 - 804) Poster Discussion 19: Dosimetry.....................................................................................................................................................(abs. 805 - 816) 20: Head and neck.............................................................................................................................................(abs. 817 - 828) Proffered Papers Highlights of Proffered Papers - Latest Clinical Trials....................................................................................(abs. 829 - 834) Young lunch symposium + networking Increasing the impact of your research. .........................................................................................................(abs. 835 - 839) Symposium Lethal DNA double strand breaks production: Quality over quantity?........................................................(abs. 840 - 843) Joint Symposium ESTRO-EANO: Twists and turns of brain irradiation. .....................................................................................(abs. 844 - 847)

Debate This house believes that an intensive follow up for high-risk breast cancer patients should be considered. ......... (abs. 848 - 853) Symposium Challenging the traditional margins for microscopic diseases.....................................................................(abs. 854 - 857) Adapting to changes on different time scales................................................................................................(abs. 858 - 861) Debate This house believes that brachytherapy is a dying art. .................................................................................(abs. 862 - 867) Symposium Mobility for radiation oncology professionals................................................................................................(abs. 868 - 874) Mini-Oral 21: Radiomics & modelling...............................................................................................................................(abs. 875 - 882) 22: AI, big data, automation. ............................................................................................................................(abs. 883 - 890) Poster Discussion 21: Implementation of new technology & techniques...................................................................................(abs. 891 - 902) 22: Gynaecological.............................................................................................................................................(abs. 903 - 914) Award Lecture K Breur Award....................................................................................................................................................(abs. 915 - 916) Donal Hollywood Award. ........................................................................................................................................... (abs. 917) Proffered Papers Health economics..............................................................................................................................................(abs. 918 - 923) CNS......................................................................................................................................................................(abs. 924 - 929) Breast..................................................................................................................................................................(abs. 930 - 935) Multicentre validation studies..........................................................................................................................(abs. 936 - 941) Inter-fraction motion and adaptive radiotherapy..........................................................................................(abs. 942 - 947) Dosimetry & treatment planning.....................................................................................................................(abs. 948 - 953)

TUESDAY 10 MAY 2022

Teaching Lecture Toxicity vs tumour control: What makes a good plan?........................................................................................... (abs. 954) How can omics lead to personalised radiation oncology?..................................................................................... (abs. 956) Is endometrial cancer ready for treatment individualisation based on molecular risk factors?........................ (abs. 957) Hypofractionation for the management of postoperative PCa............................................................................. (abs. 958) Deformable registration for dose accumulation: Current status and future challenges.................................... (abs. 959) Immunotherapy and radiotherapy: Basics for physicists....................................................................................... (abs. 960) Calculating margins correctly: Abracadabra with numbers?. .......................................................................(abs. 961 - 962) Symposium Anal cancer.........................................................................................................................................................(abs. 963 - 968) Joint Symposium ESTRO-ESR: Imaging biomarkers for personalised radiotherapy.................................................................(abs. 969 - 972) ESTRO-ESGO: Joint guidelines on the management of vaginal cancer. .......................................................(abs. 973 - 976) Symposium Fractionation for external beam radiation therapy in early breast cancer: State-of-the-art.....................(abs. 977 - 979) Medical physicists should be directly involved in the design, execution and interpretation of clinical trials. .................................................................................................................(abs. 980 - 983) Modelling of complex systems and interactions............................................................................................(abs. 984 - 986) Symposium Changes in disease pattern after the pandemic. ...........................................................................................(abs. 995 - 998) Adaptation and automation: The new frontier in radiotherapy................................................................ (abs. 999 - 1001) HPV-related squamous cell carcinoma: Is it time for de-intensification?. .............................................. (abs. 1002 - 1005) Debate This house believes that short-course radiotherapy is the ideal schedule as part of total neoadjuvant therapy programs for rectal cancer........................................................................ (abs. 1006 - 1011) Symposium Spatial and spatio-temporal fractionation................................................................................................. (abs. 1012 - 1014) Modelling at the voxel level: Dose and image-data mining. .................................................................... (abs. 1015 - 1018) Changing the radiation medicine paradigm.............................................................................................. (abs. 1019 - 1021) Pitch Session Closing Session: Which innovations will have the greatest impact in radiotherapy by 2030?.............. (abs. 1022 - 1027)

DIGITAL POSTERS Education in Radiation Oncology................................................................................................................ (abs. 1030 - 1034) Health economics / health services research............................................................................................ (abs. 1035 - 1054) Other.............................................................................................................................................................. (abs. 1055 - 1072) Head and neck.............................................................................................................................................. (abs. 1073 - 1122) CNS................................................................................................................................................................. (abs. 1123 - 1169) Haematology................................................................................................................................................. (abs. 1170 - 1174) Breast............................................................................................................................................................. (abs. 1175 - 1238) Lung............................................................................................................................................................... (abs. 1239 - 1281) Upper GI........................................................................................................................................................ (abs. 1282 - 1310) Lower GI. ....................................................................................................................................................... (abs. 1311 - 1329) Gynaecological.............................................................................................................................................. (abs. 1330 - 1357) Biomarkers.................................................................................................................................................... (abs. 1358 - 1362) Urology.......................................................................................................................................................... (abs. 1363 - 1426) Sarcoma/Skin cancer/malignant melanoma.............................................................................................. (abs. 1427 - 1438) Paediatric tumours................................................................................................................................................... (abs. 1439) Mixed sites/palliation................................................................................................................................... (abs. 1440 - 1476) Inter-fraction motion management and offline adaptive radiotherapy ................................................. (abs. 1477 - 1493) Applications of ion beam treatment planning........................................................................................... (abs. 1494 - 1509) Applications of photon and electron treatment planning........................................................................ (abs. 1510 - 1523) Dosimetry...................................................................................................................................................... (abs. 1524 - 1590) Imaging acquisition and processing........................................................................................................... (abs. 1591 - 1633) Implementation of new technology and techniques................................................................................ (abs. 1634 - 1687) Intra-fraction motion management and real-time adaptive radiotherapy............................................. (abs. 1688 - 1723) Optimisation and algorithms for ion beam treatment planning............................................................. (abs. 1724 - 1731) Optimisation and algorithms for photon and electron treatment planning.......................................... (abs. 1732 - 1747) Physical aspects of quantitative functional and biological imaging........................................................ (abs. 1748 - 1754) Radiomics, modelling and statistical methods.......................................................................................... (abs. 1755 - 1789) Brachytherapy: Breast. ............................................................................................................................................ (abs. 1790) Brachytherapy: Gynaecology....................................................................................................................... (abs. 1791 - 1800) Brachytherapy: Physics................................................................................................................................ (abs. 1801 - 1806) Brachytherapy: Head and neck, skin, eye.................................................................................................. (abs. 1807 - 1812) Brachytherapy: Urology (prostate, bladder, penile).................................................................................. (abs. 1813 - 1819) Normal tissue radiobiology......................................................................................................................... (abs. 1820 - 1823) Tumour radiobiology. .................................................................................................................................. (abs. 1824 - 1825) Immuno-radiobiology. ................................................................................................................................. (abs. 1826 - 1828) Patient preparation, positioning and immobilisation............................................................................... (abs. 1829 - 1853) RTT education, training, advanced practice and role developments...................................................... (abs. 1854 - 1861) RTT service evaluation, quality assurance and risk management........................................................... (abs. 1862 - 1870) RTT treatment planning, OAR and target definitions ................................................................................ (abs. 1871 - 1893)

ABSTRACTS

ESTRO 2022

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Saturday 7 May 2022

Teaching lecture: Developing a national infrastructure for proton beam therapy trials

SP-0001 Developing a national infrastructure for proton beam therapy trials

C. Nutting

United Kingdom Abstract not available

Teaching lecture: The radiobiological clock in 2022

SP-0002 The radiobiological clock in 2022

M. Pruschy

Switzerland Abstract not available

SP-0003 The radiobiological clock in 2022

L. Dubois

The Netherlands Abstract not available

Teaching lecture: Stereotactic radiotherapy in lung: Recent advances

SP-0004 Stereotactic radiotherapy in the lung: Recent advances

T. Finazzi 1

1 University Hospital Basel, Clinic for Radiotherapy and Radiation Oncology, Basel, Switzerland

Abstract Text This teaching lecture will provide an overview of recent advances in stereotactic ablative radiotherapy (SABR) for lung tumors. Topics will include novel technical approaches, such as magnetic resonance-guided radiation therapy, as well as clinical developments in the field of lung SABR. An outlook on potential future directions will be given, and questions from the audience will be invited during the discussion.

Teaching lecture: Palliative radiotherapy: Established standards and emerging concepts

SP-0005 Palliative radiotherapy: Established standards and emerging concepts

Y. van der Linden

The Netherlands Abstract not available

Teaching lecture: Improving radiotherapy outcomes for vaginal tumours using a joint target concept

SP-0006 Improving radiotherapy outcomes for vaginal tumours using a joint target concept

H. Westerveld

The Netherlands Abstract not available

Teaching lecture: Commissioning and quality assurance of commercial in vivo dosimetry systems

SP-0007 Commissioning and quality assurance of commercial in vivo dosimetry systems

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M. Esposito 1

1 Azienda Sanitaria USL Toscana Centro, S.O.C. Fisica Sanitaria, Firenze, Italy

Abstract Text In vivo dosimetry (IVD) is the last step of the quality assurance (QA) process in radiotherapy, providing an end-to end verification of the whole treatment. Modern IVD devices should be able to verify static and dynamic dose delivery and determine the most frequent and severe errors. An ideal IVD systems should act as a binary classifier by flagging incorrect fractions. Even if diodes are still the most popular devices for IVD, the use of electronic portal image device (EPID) is increasing, due to it's broad avalability and semplicity. Moreover, with EPID, the absorbed dose can be estimated not only in a point but also in a plane or even in 3D. The commissioning of an IVD device is aimed to verify the correct system implementation by testing the device functionality. It can be roughly divided in two parts. The first part consists in characterizing the basic device properties. The ability to correctly reproduce the delivered dose is therefore assessed. These tests includes: dose linearity response, dose rate response, energy and angular dependence, field size response. The goal of the second commissioning part is to assess the specificity and sensitivity to determine typical errors. To this aim, realistic errors should be simulated and tested, against errors free treatments. ROC curve are constructed to quantify the device sensitivity and specificity. In this lecture, after a brief general introduction about the different strategies for IVD, the commissioning and quality assurance experiences, reported in literature, are reviewed. In the final part, a commissioning and QA protocol for EPID IVD, applicable to all kind of sofware, is presented.

Teaching lecture: Monte Carlo dose calculation in modern day radiotherapy

SP-0008 Monte Carlo dose calculation in modern day radiotherapy

R. Kueng 1

1 Inselspital, Bern University Hospital, and University of Bern, Division of Medical Radiation Physics and Department of Radiation Oncology, Bern, Switzerland Abstract Text Today’s radiation therapy techniques strive to increase treatment accuracy (e.g. by using image guidance), improve dose conformity (e.g. by applying modulated photon or particle therapy) and cope with day-to-day uncertainties (e.g. by enabling adaptive therapy). To reliably pre-estimate the outcome of such a complex radiation therapy treatment, an accurate prediction of the dose distribution in the patient is crucial. Monte Carlo (MC) dose calculation algorithms are nowadays considered the gold standard for accurate dose prediction. This teaching lecture will cover the key concepts of MC dose calculation and a give brief recap of its history. The drawbacks and benefits of the stochastic approach to the problem will be discussed and techniques of speeding up MC dose calculation will be lined out. The lecture will finally give an overview of the application of MC methods in modern day radiation therapy and attempt to give an outlook on its progression in the field over the next years.

Teaching lecture: Patient education in 2022: Does the patient know better?

SP-0009 Use of social media, oncology platforms and other tools as base for education

J. De Munter

Belgium Abstract not available

Symposium: Education in radiation oncology: Advances and opportunities

SP-0011 Can virtual learning methods like VERT improve education in radiation oncology?

C. Poole 1

1 Applied Radiation Therapy Trinity College Dublin, Discipline of Radiation Therapy, Trinity St James’ Cancer Institute, , Dublin, Ireland Abstract Text Emergence of virtual learning environments (also referred to as simulated environments) in medical education has enabled educators to bring ‘real experiences’ to the classroom environment. The aim of this technology is to allow students to develop their clinical skills in a safe structured environment. Numerous educational studies demonstrate its role in effectively teaching procedural competence and clinical skills to learners in various medical specialities; however, only recently have we seen its application to radiation oncology education emerge. Simulated teaching has become more prominent in radiation therapy (RT) curricula due to the launch of ‘Virtual Environment for Radiotherapy Training’ VERTTM in 2007. This virtual RT environment features a bunker with a linear

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accelerator and facilitates hands on learning in a simulated clinical environment. Learning in a simulated environment enables active student participation where students can make mistakes and learn from them with no risk to patients. Such safe environments support two-way communication between the student and the educator, allowing for individualised feedback and possibly enhanced retention of clinical skills for the student. Learning in a safe engaging environment promotes active learning and therefore deep learning and helps students to transition from being passive learners in second level education to active learners in universities. Benefits of simulated education is not just limited to teaching procedural skills, it can also be used to support assessment, teaching, and learning in communication, planning concepts, imaging, inter-professional interactions and patient management case-based scenarios. Despite the many benefits to simulation, there are some challenges and barriers to its implementation into radiation oncology curricula. One consideration is the possible increase in cost compared to traditional teaching methods. Time is also a perceived barrier due to the additional time needed to develop and teach on simulated programmes. However, these barriers could possibly be overcome by sharing resources between institutions.Further concerns surrounding simulated education is the false confidence and sense of security students may have in their skills due to lack of variation and complexity in the patient cases provided in the clinical environment. Simulated environments also lack the realism of the clinical environment in the senior years when students are expected to work under time pressures in stressful environments. Despite these concerns, VERTTM is an effective educational tool that can support and enhance students clinical learning. It should be integrated into the design of radiation oncology curricula due the positive benefits for all key stakeholders (student, educators, and patients). While beneficial, VERTTM does not exclude the need for students to work in clinical environments. The future of radiation oncology education is exciting as educators have the opportunity to integrate emerging multimedia software to support and educate our future practitioner and medics. D. Di Perri 1 , D. Hofstede 1 , A. Postma 2 , C.M. Zegers 1 , L. In’t Ven 1 , F. Hoebers 1 , W. van Elmpt 1 , L. Verheesen 1 , H. Beurskens 1 , E.G. Troost 3 , I. Compter 1 , D.B. Eekers 1 1 Department of Radiation Oncology (Maastro), Maastricht University Medical Center+, GROW School for Oncology, Maastricht, the Netherlands., -, Maastricht, The Netherlands; 2 Department of Radiology and Nuclear Medicine MUMC+, Maastricht, The Netherlands , -, Maastricht, The Netherlands; 3 Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany , -, Dresden, Germany Purpose or Objective Accurate and uniform contouring of organs at risk (OARs) is essential to optimise the radiation treatment (RT) plan and to minimise the risk of toxicity. Furthermore, accurate contouring in clinical practice on a large scale would allow more accurate dose estimation as input for normal tissue complication probability models. In this context, 10 OARs were introduced in the updated European Particle Therapy Network (EPTN) neurological contouring atlas (i.e., amygdala, caudate nucleus, corpus callosum, fornix, macula, optic tract, orbitofrontal cortex, periventricular space, pineal gland, and thalamus). Despite the use of this atlas, inter-individual variations in contouring may persist. To further facilitate accurate contouring of these OARs and training of new delineation professionals, educational movies were developed based on experience gathered during multidisciplinary contouring training sessions. Materials and Methods Weekly contouring training sessions designed for members of different disciplines involved in contouring [i.e. radiation oncologist (RTO), radiation technologist (RTT), clinical scientist, and medical student] were organised in our RT department. During each weekly session, 1 of the 10 new OARs was introduced. Before the session, participants were asked to perform the contouring on a patient image set (CT/MR scans) based on the updated EPTN atlas. Then, during each session, inter-individual delineation differences were discussed with an experienced neuroradiologist. This OAR was subsequently delineated again during the next weekly sessions on new patient study sets until visual contouring agreement was reached. Results The sessions lead to a clear reduction in inter-individual contouring variability (Fig. 1). Based on the observations made during the training sessions, educational movies describing the OARs were developed in order to be used by the different professionals involved in contouring. These movies show the anatomical boundaries of the OARs and provide tips and tricks to help with common difficulties and errors experienced during contouring. The movies were reviewed by an experienced neuroradiologist, two RTTs, two RTOs who did not participate to the meetings, as well as by an external RTO expert in neuro-oncology. SP-0012 Virtual reality and other advanced learning environments in oncology training D. Kok Australia Abstract not available SP-0013 Weekly contouring rounds and education movies to improve organ at risk delineation in neuro-oncology

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