ESTRO 2025 - Abstract Book

S4265

RTT - Education, training, advanced practice and role developments

ESTRO 2025

9 Radiotherapy, Inholland University of Applied Sciences, Haarlem, Netherlands. 10 Public Health and the Environment, National institute, Bilthoven, Netherlands. 11 Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, Netherlands Purpose/Objective: The number of proton therapy (PT) centres, especially in Europe, is growing rapidly [1]. A number of guidelines on patient selection, and treatment planning have been formulated on national and international levels, but so far no guidelines have been developed that specifically describe workflow steps of radiation therapists (RTTs) and dosimetrists in PT. The Erasmus+ "Towards a Sustainable RTT network" (TaSeRnet) project aims to harmonize and enhance the quality of PT practices among RTTs and dosimetrists in Europe by developing guidelines and education [2]. A key objective of this project is to achieve consensus on workflow steps for RTTs and dosimetrists. Material/Methods: A Delphi consensus methodology was used and applied to 26 statements, based on results of an RTT workshop. The process included three rounds, each involving expert reviews of statements for clarity, neutrality, and consistency. The voting panel was formed by selected PT centres based on predefined criteria and participants were invited to join by submitting a registration form. To reach consensus, an agreement from at least 66% of the voting panel was needed. Strong consensus required ≥80% agreement. Results: Forty RTTs and dosimetrists from 10 PT centres in Europe were invited to participate. The results of the Delphi process are summarized in Figure 1. Consensus was reached on scanning protocols, patient positioning and RTT autonomy in re-scan decisions. RTTs can segment organs at risk with physician review, standardized window level settings and knowledge on artificial intelligence are needed. In treatment planning an individual beam setup should be used. Regarding image guidance, consensus was reached on automatic matching, and RTT-only workflows based on traffic light protocols. Furthermore, RTTs working with children need specific training. For Quality Assurance, a more thorough treatment plan check is necessary compared to photon therapy. In treatment execution, knowledge of uncertainties in PT as well as standardizing transfer on details on patient positioning is agreed. Finally, consensus was reached on RTT-only workflow for plan evaluation and RTT involvement in plan adaptation meetings. However, no consensus was achieved on RTTs' role in European knowledge sharing or dry runs without a patient present.