ESTRO 2023 - Abstract Book

S272

Sunday 14 May 2023

ESTRO 2023

Teaching Lecture: Global advancements in radiation therapist advanced practice

SP-0345 Global advancements in radiation therapist advanced practice N. Rozanec Canada

Purpose or Objective In the post-pandemic era, many countries continue to face significant health-human resource challenges, which have reached crisis levels across the globe. As healthcare resources become more limited, there is a need to transform and expand current models of healthcare delivery to meet the growing needs of our increasing patient population. This session will demonstrate how global advancements in Advanced Practice Radiation Therapy (APRT) can be used as important and innovative tools for facing and overcoming these challenges as we continue to strive to provide safe, high quality cancer care. Materials and Methods Task shifting is a method in which a health care professional delegates tasks to another healthcare professional to improve efficiency and alleviate bottlenecks in the healthcare system. This model is endorsed by the World Health Organization and is a strategy already in use in the healthcare sector of many countries to rapidly expand healthcare services. Implementation of an APRT is one way in which some tasks traditionally performed by a radiation oncologist are delegated to an APRT to improve and increase the efficiency of cancer care. In 2021, the CAMRT formally recognized that an APRT-mediated model of care is a novel approach to harness existing expertise and human resources for the benefit of patients, particularly those receiving palliative care. This approach has been successfully implemented in several countries around the world, including Canada, Australia, New Zealand and the UK, and applied to the full spectrum of cancer care. Results While APRT roles are structured differently around the world and can differ significantly depending on the individual needs of a particular jurisdiction, they consistently demonstrate the positive impacts of task shifting on cancer care, education and research transnationally. This is evidenced in the growing body of literature on APRT roles and impacts. Over the last few years, we have witnessed the rapid expansion of virtual care, and subsequently an increase in tools that support virtual collaborations. This has allowed greater global support, mentorship and partnerships for local jurisdictions interested in implementing APRT roles in cancer care. Conclusion In conclusion, the implementation of APRT roles demonstrates the success of task shifting and provides an innovative solution to expansion and improved efficiency of radiation therapy treatment. As APRTs continue to embark on local, nation and global collaborations, sharing both the successes and challenges, we continue to build an international toolbox to assist with rapid expansion of cancer services and alleviation of bottlenecks along the cancer care journey. Overall, this demonstrates the importance of the sustainability of APRT roles to ensure continued improvement and broader access to cancer care world-wide.

Joint Symposium: ESTRO-EORTC: Next generation clinical trial design: A multidisciplinary effort

SP-0346 -0349

Abstracts not available for this session

Symposium: Senescence in cancer and stromal cells: Opportunities to improve radiotherapy response

SP-0350 Effects of irradiation on lung cancer associated fibroblasts (CAFs) I. Martinez-Zubiaurre 1 , R. Berzaghi 1 , K. Lode 1 , T. Hellevik 2 1 University of Tromsø, Clinical Medicine, Tromsø, Norway; 2 University Hospital of Northern Norway, Radiation Oncology Dpt., Tromsø, Norway

Abstract Text Background

Cancer-associated fibroblasts (CAFs) represent a heterogeneous population of connective tissue cells that are both numerically and functionally prominent constituents of solid tumors. The role that CAFs play on tumor responses to radiotherapy remains poorly understood. This study was undertaken to explore changes provoked by radiotherapy on CAF abundance and functions. Methodology Phenotypic and functional changes induced by radiation was studied on freshly primary human NSCLC CAFs. The impact that RT has on CAFs in vivo was also studied in three different preclinical models comprising LLC (lung cancer), CT26 (colon cancer) and 4662PDA (pancreatic cancer). Subcutaneous tumors were irradiated at different radiation regimens and the levels of tumor-associated CAF markers were analyzed 1-week post-RT by flow cytometry, histology, IHC and non-invasively by the use of a CAF-specific PET imaging radiotracer. In parallel, the effects of RT on CAFs were studied in a cohort of cervical cancer patients treated with neoadjuvant chemoradiotherapy, and levels of aSMA-positive cells in tumor tissues was compared before and after treatment. The impact of aSMA and collagen expression on treatment response has been investigated. Results Our in vitro data show a dose-dependent induction of cell senescence in CAFs by radiation, with a concomitant reduction of the proliferative and migratory capacity. The expression of CAF activation markers FAP-1, FSP-1, PDGFR / and α -SMA remained unchanged following IR, whereas the expression of podoplanin was reduced. In vivo observations indicated that radiation did not alter the amount or the phenotype of CAFs in LLC or CT26 tumors, whereas the levels of CAFs in 4662PDA