ESTRO 2024 - Abstract Book

S139 ESTRO 2024 Such an approach could be valuable not only for patients undergoing radiotherapy but also in other settings, e.g. active surveillance for prostate cancer, as dietary fibre may slow PSA progression. ‘Co-production’ with patient partners is essential in designing such randomised clinical trials. A number of factors need to be taken into account, including tolerability of the fibre (e.g. some cause bloating and wind), acceptability of producing repeated faecal samples for microbiota analysis and acceptable frequency of being asked to complete Patient Reported Outcome Measures and Quality of Life questionnaires. If successful, dietary fibre supplementation would be a relatively inexpensive, low toxicity option to achieve tumour radiosensitisation while minimising intestinal side effects, and therefore could be of benefit in patients with pelvic malignancies. It would also be worthwhile exploring such an approach in other cancers. Invited Speaker

3596

The optimisation

Daniella Elisabet Oestergaard

University Hospital of Copenhagen, Oncology, Copenhagen, Denmark

Abstract:

Image-guided radiotherapy (IGRT) have increased precision of the treatments and is a key component for new technologies such as adaptive radiotherapy. Our patients fortunately live longer and, hence might experience the need for re-irradiation in overlapping anatomical areas. This calls for relevant use of image-guidance and image related dose and, similar to the ImageGently approach in radiology, application of the ALARA principle even for image related radiation. The literature reveals many relevant parameters to optimize image-guidance, e.g., quantum noise, dose, picture quality, but also uncovers some issues related to the anatomy such as patient size and organ movement. The latter harder to optimise. Optimisation of IGRT need to be assessed systematically due to the many different parameters and the complexity followed by the possibility of combining deep learning and AI to the imaging process, but optimisation also need to include a clinical context. What treatment is needed – curative or palliative, multiple fractions, or single dose? And what image guidance is needed and appropriate to achieve the best treatment. Addressing optimisation of image guidance is complex and to the majority of the clinical staff the image might seem like a small, standardized step in the radiation course. However, the clinical dilemmas occur throughout the course when the anatomy changes, when we need to re-irradiate in same regions of the body or when we deal with late effects in the outpatient clinic. Hence, addressing optimisation of image-guidance is a multi-disciplinary task to raise the most relevant questions and requires resources and incorporation to the workflow within the radiation clinic.

3597

The target: Who needs what?

Floris J Pos

Netherlands Cancer Institute, Radiation Oncology, Amsterdam, Netherlands

Abstract: