ESTRO 2025 - Abstract Book

S64

Invited Speaker

ESTRO 2025

reirradiation care including the defining the role of RTT within the team. Our institution recently implemented a new team workflow for communicating, documenting and accounting for prior RT courses, as these points have become known as potential points of weakness during reirradiation. There is currently substantial variation is reirradiation workflows across institutions in terms of the responsibilities of different tasks and available technologies. Common elements to all are that they require both continuous multi-disciplinary communication (radiation oncologist, RTT dosimetrist and physicist) and discipline-specific tasks to inform clinical decision making, plan design, evaluation and QA of re-irradiation cases. While the role of oncologists and physicists in reirradiation has been more clearly defined in the literature the role for RTTs is less clear. Our research group has led an ongoing pan-Canadian survey of RTTs patterns-of-practice in reirradiation. Preliminary results show that 30% indicated reirradiation scope of practice is moderately to substantially different from conventional RTT practice. RTTs consistently reported performing patient care and treatment delivery with reirradiation. However, over two thirds of RTTs rarely or were unsure if they used deformable image registration or applied iso-effective dose corrections (e.g. EQD2, BED). Over 60% of RTTs of were interested in additional reirradiation education on radiobiology, physics and patient care specific to reirradiation. Published reirradiation ESTRO-EORTC consensus guidelines have recommended the use of these technical activities, therefore further RTT training would seem prudent to address the knowledge and practice gap. Unlike the technical and clinical aspects however, there is a dearth of guidelines and literature on patient education and supportive care needs for reirradiation patients. An ongoing quality improvement (QI) study of our institutions’ standard pre-treatment patient education with an RTT included 110 patients undergoing repeat RT or reirradiation. Patients with prior RT were significantly more likely to indicate this RTT-led education met their information needs compared to first-time patients, with 92% reporting it helped them prepare for RT and 75% that it provided new information. Despite the prior patient experience and RTT-led education session, approximately 20% of reirradiation indicated they still required more other information with some aspect of the RT process. Efforts are ongoing to explore what the unmet need of reirradiation patients are. Collectively these initiatives re-envision reirradiation workflows with RTTs as integral members of the care team, enabling technically precise reirradiation, seamless delivery with personalized patient support.

4749

Speaker Abstracts Evolving practice: How re-irradiation is shaping the role of the RTT Aileen Duffton Radiotherapy, Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom

Abstract:

Re-irradiation brings unique challenges to the radiotherapy pathway. These include technical challenges which differ across anatomical sites and are dependent on the location of the target volume and adjacent organs at risk. Complex treatments require the expertise of all members of the team, who can develop and implement optimal strategies, throughout the full pathway. To ensure the optimal treatment of patients in this setting, communication of the multi-professional team (MPT) is essential. An increased interest in reirradiation can be seen as an opportunity to consider how the RTT role can evolve to improve patient care and support increased service delivery. RTTs have a strong history of developing advanced practice roles through image-guided RT (IGRT) and adaptive RT (ART), where RTT led services have been successful, and well evidenced. Like these developments, reirradiation requires critical thinking, autonomous decision making and increased levels of responsibility. Such changes to scope of practice can be delivered through training, education and competency.