ESTRO 2022 - Abstract Book

S302

Abstract book

ESTRO 2022

conservative treatments consist of compression therapy, physical exercise, reducing risk factors like a high BMI, adequate skin-care, and treatment of pain and psychosocial problems. The effectiveness of manual lymph drainage is disputed by several systematic reviews with a meta-analysis concluding that it has no or very little additive effect on compression therapy [4]. During the maintenance phase usually, elastic compression sleeves are used, in combination with self- management tools. Combining pneumatic compression with manual lymph drainage has been suggested but not sufficiently evaluated. When conservative measures do not have sufficient effect, microsurgical approaches constructing an anastomosis, have been shown to be effective in reducing excess lymphatic fluid in early-stage lymph-edema [5]. Other more experimental surgical strategies that are being explored to deal with severe lymph-edema, consist of vascularized lymph node transfer and liposuction. References 1. Armer JM & Stewart BR. Lymphology. 2010; 43:118–27. 2. 2016 Consensus document of the International Society of Lymphology. Lymphology. 2016;49:170–84. 3. Gross JP, et al. Int J Radiat Oncol Biol Phys 2019; 105: 649– 58.

4. McLaughlin SA et al. Ann Surg Oncol. 2017, doi: 10.1245/s10434-017-5982-4. 5. McLaughlin SA et al. Ann Surg Oncol. 2017 doi: 10.1245/s10434-017-5964-6. 6. Rockson SG. Curr Treat Options Cardiovasc Med. 2012;14:184–92 7. Waldstein C, et al. J Med Imaging Radiat Oncol 2021.doi: 10.1111/1754-9485.13318. 8. Yue T, et al. Clin Breast Cancer. 2015;15:301–6.

Teaching lecture: Fractionation and biology in bladder cancer

SP-0340 Fractionation and biology in bladder cancer

A.Choudhury

United Kingdom Abstract not available

Teaching lecture: Artificial intelligence and brachytherapy: Current reality and perspectives

SP-0341 The physician point of view

L. Tagliaferri 1

1 Policlinico Universitario Agostino Gemelli IRCCS , Gemelli ART (Advanced Radiation Therapy), Rome, Italy

Abstract Text Since Radiotherapy is a discipline strongly based on technological improvement, it can’t disregard a specific training and a precise quality assurance especially in the field of brachytherapy (Interventional Radiotherapy, BT, IRT). To offer the best treatment to the patient, the introduction of the Intelligence Artificial Guided Procedure (IAGP) and automation in clinical practice could be very useful. The impact of this introduction will not be negligible and could improve all phases of the interventional radiotherapy workflow: 1) first consultation of the patient with indication for BT 2) implant 3) delineation 4) planning 5) treatment 6) follow-up and other therapeutic indications. The utility of AI is mostly based on the support of big data , deep learning , algorithmic innovation and powerful neural network models, whereas automation using artificial intelligence has already proved its use speeding up the “contouring process” through autosegmentation in many fields of cancer care. In interventional radiotherapy (IRT), AI could be an important upgrade in the optimization of implant geometry, applicators location in treatment planning and source position in targets, avoiding organs at risks (OAR’S). Physicians and physicists can find a real benefit in obtaining an adequate target coverage and optimal OARs avoidance, using machine learning and effective algorithms. It also allows to perform the adaptive re-planning procedure during treatment. AI may also find an important role in treatment planning, by sparing a great amount of time, which depends especially on the physicist’s and physician’s knowledge and expertise. The field of treatment planning can be very different, not only across centers, but even in the same center because of the presence of different planners; this also explains the need of systems integrated with AI. Thanks to an increasing spread of Decision Support Systems (DSS), based on large database and radiomics, physicians can be provided with a huge amount of data that can improve clinical practice, using predictive models and leading to a personalized cancer care. This talk will aim to present and discuss how the introduction of Intelligence Artificial Guided Procedure (IAGP) and Automation could change the clinical practice and the interventional radiotherapy workflow.

SP-0342 The physicist point of view

N. Nesvacil

Austria Abstract not available

Teaching lecture: Robust treatment planning in particle therapy: Clinical implementation and potential pitfalls