ESTRO 2025 - Abstract Book

S92

Invited Speaker

ESTRO 2025

4800

Speaker Abstracts The role of hypofractionation to address the workforce challenge Alison C Tree Radiotherapy, The Royal Marsden NHS Foundation Trust, Sutton, Surrey, United Kingdom

Abstract:

This talk will focus on the historical reasons why fractionation became the accepted standard of care across all cancers and the scientific data which led us to question this dogma. Examples of data supporting moderate hypofractionation will be shared across breast and prostate cancer. The evidence supporting a move to ultrahypofractionation/stereotactic body radiotherapy in common cancers will be explored, including the limitations of this evidence.

Moving to a smaller number of large fractions requires additional technical accuracy and training for staff. A range of delivery platforms can be used and the relative merits of each will be discussed.

Finally this session will address novel radiotherapy indications and where ultrahypofractionation is likely to lead us next.

4801

Speaker Abstracts AI-driven technical solutions for auto-contouring and treatment planning: Can it improve equitable access to radiotherapy worldwide? Indranil Mallick Department of Radiation Oncology, Tata Medical Center, Kolkata, India

Abstract:

Modern radiotherapy planning and treatment involve several key technical steps requiring high expertise and training for optimal execution. In low-resource settings, the availability of appropriately trained manpower as well as the availability of software licences can be a challenge. This leads to delays or the inability to provide the most appropriate conformal planning solution for all the patients. Artificial intelligence (AI)-driven solutions could potentially be a solution for some domains of this problem. Several commercial and academic solutions for auto segmentation and auto-planning are now becoming available. While this is opening doors to potential automation, key hurdles still exist in terms of cost, validation, and availability of information technology (IT) infrastructure. There is a need to study both the effectiveness and implementation of these solutions in a global setting. The ARCHERY trial is validating an academic solution in several centers worldwide and will provide key information on the benefits of AI-driven technical solutions. Many other centers, some in low-resource countries, have also forayed into developing local solutions, that could be scaled up to a much larger level. The key to the successful implementation of these solutions is bridging the last mile gap - setting up and maintaining low-cost workflows, and rapid incorporation of changes in standards of segmentation and dose-fractionation. Governments also have a role to play in encouraging innovation, assisting validation of existing solutions, providing IT infrastructure and maintaining technical standards.