ESTRO 2025 - Abstract Book

S4229

RTT - Education, training, advanced practice and role developments

ESTRO 2025

1966

Proffered Paper Pan-Canadian Assessment of Image Guided Adaptive Radiation Therapy and the Role of the Radiation Therapist Winnie Li 1,2 , Amanda Moreira 1 , Yat Tsang 1,2 , Patricia Lindsay 1,2 , Peter Chung 1,2 , Tara Rosewall 1,2 1 Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Canada. 2 Department of Radiation Oncology, University of Toronto, Toronto, Canada Purpose/Objective: Adaptive radiation therapy (ART) is a close-looped process where anatomic changes observed during treatment are identified, leading to plan modification prior to treatment delivery. ART is increasingly implemented in clinical practice due to advances in technology, encompassing both offline modifications between treatment fractions and real-time online adjustments during a treatment session. This study aimed to assess the patterns of ART practice across Canada and explore the impact these technologies have on the roles and responsibilities of Canadian Radiation Therapists (RTTs). Material/Methods: A 30-question survey was distributed via email to RTT managers at all cancer centers in Canada (n=48). The survey questions included centre demographics, presence of offline and/or online ART activities as standard of care, corresponding roles and responsibilities of the multidisciplinary team, and training activities. Prior to distribution, the questionnaire was piloted for clarity and face validity by four RTTs with expert knowledge of the ART process. The survey was administered electronically and remained open for three weeks. Responses were analyzed using descriptive statistics. Results: Thirty-two of the 48 centers responded (67% response rate), representing all ten provinces. Of these, 25 centers (78%) currently practice ART: all of them implement offline ART, while 5 also practice online ART. Among the centers using offline ART, the brain was the least commonly treated site (56%), while head and neck treatments were adapted in almost all centers (except one). Five centers (16%) reported daily online ART, primarily for prostate patients, though brain, upper GI, and lower GI treatments were also adapted in some centers. The most common barriers to ART implementation were technical limitations and lack of resources. RTTs were responsible for 50% of offline ART tasks and 58% of online ART tasks, with the most significant change being the inclusion of target delineation in their daily responsibilities. Conclusion: The adoption of ART across Canada is varied, with offline ART being more widely practiced than online ART, which remains limited by technical and resource constraints. As centers move toward incorporating online ART, the roles of RTTs will need to be redefined, with a focus on upskilling to meet the demands of this emerging treatment paradigm.

Keywords: Adaptive Radiation Therapy, Therapist Roles

References: N/A