ESTRO 2025 - Abstract Book

S63

Invited Speaker

ESTRO 2025

radiotherapy techniques, each with its own dosimetric challenges and technical requirements, making automation particularly demanding. The integration of automated treatment planning into clinical workflows requires a structured approach, including software implementation, staff training, and validation processes. Different automation strategies, such as multicriteria optimization (MCO) and knowledge-based planning (KBP), offer distinct advantages in addressing these challenges. MCO enables real-time trade-offs between competing dosimetric objectives, improving plan personalization, while KBP leverages machine learning models trained on high-quality plans to ensure consistency and reduce variability. Despite its advantages, automated treatment planning faces challenges related to software integration, clinical acceptance, and the need for adaptable algorithms that can handle a wide variety of target volumes and anatomical configurations. Strategies to overcome these barriers, including hybrid approaches combining automation with expert planner input, will be discussed. Looking ahead, further optimization through the integration of different algorithms holds great potential for improving automation, personalization, and overall patient outcomes. This presentation will provide insights into the real-world impact of automated treatment planning in breast cancer radiotherapy, emphasizing the importance of addressing target heterogeneity and reviewing existing evidence from the literature.

4747

Speaker Abstracts Navigating challenges in reirradiation treatment planning: Strategies for radiation therapists Madalyne Day Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland

Abstract:

Reirradiation presents complex challenges, requiring treatment planners to navigate uncertainties and limitations to deliver safe and robust treatment plans. Key obstacles include difficulties in obtaining and evaluating previous treatment information, the lack of reirradiation-specific tools in commercial treatment planning systems, uncertainties in image registration and dose accumulation, and the limited availability of literature and standardised recommendations in this space. The culmination of these challenges can result in large inconsistencies which complicates decision making in reirradiation.

This presentation will identify challenges and considerations for treatment planning in the reirradiation setting and explore current literature, practical strategies, and future work to address these issues.

4748

Speaker Abstracts Re-envisioning re-irradiation workflows with enhanced radiation therapist expertise Michael Velec, Alvin Cuni, Neva Pang, Yat Tsang Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Canada

Abstract:

With the increasing use of reirradiation to treat new or recurrence tumors that overlap with prior radiation therapy (RT), the need for workflows that effectively manage these complex cases has emerged. The aim of this work is to report on our progress with a number of research and quality improvement studies that optimize clinical