ESTRO 38 Abstract book

S66 ESTRO 38

compensated Cone-Beam CT algorithms. The third example deals with image-based dosimetry in nuclear medicine therapy. All those examples illustrate the interest and the difficulty to access raw data, to provide new algorithms that may be difficult to insert into clinical routine.

dedicated to radiotherapy, nuclear medicine, MRI and other radiology. The future hybrid modalities in both diagnostics (PET/MR, PET/CT) and therapy (MR/linac) will be the end of the era for “One Modality Physicist”. This is a both a challenge as well as a source to opportunities to the physics profession. SP-0134 Working with radiotherapy from the perspective of US physicist E. Harris 1 1 The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Joint Department of Physics, Sutton, United Kingdom Abstract text Ultrasound can be used to guide radiation therapy of the prostate and prostate bed, breast, gynaecological cancers, and some upper abdominal sites such as liver. The integration of ultrasound with the radiotherapy workflow presents a number of challenges for the ultrasound physicist. One key issue when using ultrasound to guide radiotherapy is the requirement of spatial registration of ultrasound data with the treatment co- ordinate system which is often not straight forward; ultrasound images are rarely obtained using rectilinear spatial sampling and proprietary information regarding the transducer geometry is not easily obtained. Furthermore, the transformation of ultrasound image data into Cartesian space reduces image quality but is necessary for image display and fusion with CT and CBCT. The pitfalls associated with geometrical registration of ultrasound with the RT treatment isocentre and the importance of working with radiotherapy colleagues to understand geometrical components of the radiotherapy workflow will be discussed. QA has to be performed at a much greater frequency than is typical for the ultrasound physicist, which is commonly once per year. Traditional ultrasound imaging QA phantoms are typically not suitable to assess the use of ultrasound in radiotherapy (end-to-end testing) and for example, the development of X-ray and ultrasound compatible spatial registration phantoms and anthropomorphic test phantoms, even dynamic phantoms can be challenging. Multidisciplinary working is crucial to generate solutions to these problems. In the design of new systems, the ultrasound physicist has to appreciate there are several practical limitations associated with the radiotherapy setting which can reduce the ultrasound image quality obtainable, including: low (transducer) pressure scanning, high time-pressures, poor selection of imaging parameters, frequent rotation of skilled workforce. The need for greater automation and system redesign will be discussed, including a description of current methods to overcome these problems (used both in an RT setting and elsewhere in diagnostic ultrasound) and potential exciting new multidisciplinary research opportunities. SP-0135 Working with radiotherapy from the perspective of data/computer scientist D. Sarrut 1 , R. Simon 1 , A. Myriam 2 , C. Line 2 , B. Thomas 1 , B. Jean-Noel 3 , G. Anne-Laure 3 1 CNRS - Léon Bérard Cancer Center, Creatis, Lyon, France; 2 Léon Bérard Cancer Center, Radiation Therapy, Lyon, France ; 3 Léon Bérard Cancer Center, Nuclear Medicine, Lyon, France Abstract text I will present 3 short examples of collaborative experiences between computer scientist researchers and radiotherapy/nuclear medicine departments. The first one is the setup of radiotherapy NSCLC lung treatment using deformable image registration (DIR). The second example describes the development of motion

Symposium: Younger people and radiotherapy

SP-0136 Considerations for Younger patients receiving RT: psychological, physical, and surveillance C. Dickie 1 , N. Laperriere 1 1 Princess Margaret Cancer Centre- University of Toronto, Radiation Medicine Program, Toronto, Canada Abstract text Research has demonstrated that adolescents and young adults (AYAs) ages 15 to 39 have unique considerations for cancer care and survivorship. As they transition from pediatric to adult oncology, they also struggle with diverse life changes such as trying to establish independence and identity, a healthy separation from parents/family, employment decisions, higher education and having their own families. Studies show that this transitional period in life is more stressful than other stages with a diagnosis of cancer potentially exacerbating or adding to existing issues. This talk will provide an overview of some of the psychological, physical and surveillance issues that challenge this particular subset of patients with a focus on the supportive role a radiation therapist can play that may positively influence critical outcomes. Psychological distress is well documented in AYA survivors of childhood cancer and for AYAs undergoing therapy. In fact, there have been a series of unmet service needs identified for AYAs including issues involving emotional wellbeing, uncontrolled pain, fear, stress, anxiety, fertility preservation and sex drive / sexual health, fatigue, stressed social and romantic relationships, the inability to meet work demands, school and higher education concerns, and financial issues as they progress through their life during and after cancer therapy. Improvements in the effectiveness of cancer therapy have resulted in increased survival rates often accompanied by chronic toxicities associated with radiotherapy. Anatomical / physical issues include but are not limited to cardiopulmonary toxicity, neurocognitive dysfunction, musculoskeletal issues and secondary malignancy. Survivors also have difficulty with daily activities and physical function due to symptoms from medical interventions. Finally, surveillance considerations are important for the AYA population. A large proportion of adult survivors of childhood or adolescent cancer suffer from toxicities occurring very late and hence late effects screening is critical. In addition, the rate of secondary malignancies is higher than in the general age matched population. AYA patients should be made aware of this risk, have routine follow up, and should be informed to contact their health care team if new symptoms arise. Studies have demonstrated that AYAs frequently do not feel like they have received adequate information at discharge and are non-compliant with regular follow up. Radiation Therapists (RTTs) are in a unique position to improve the evaluation of AYAs unmet needs and management during radiotherapy. Although radiotherapy is often given at the end of the treatment trajectory, RTTs can facilitate access to services and information as the patient’s daily point of contact. Research in AYA care shows underutilization of services with associated worse overall health related quality of life and outcomes. Increasing RTT awareness of these needs, how to identify an issue, and how to develop effective strategies to address concerns has the potential to contribute to the reduction of distress in the AYA