ESTRO Annual Report 2019


ESTRO European Society for Radiotherapy & Oncology Rue Martin V, 40 1200 Brussels Belgium Follow us on WWW.ESTRO.ORG

Radiation Oncology. Together.

Optimal Health



VISION 2030 STRATEGIC AREAS From research to practice Strengthening the profession

Strengthening the Society Strengthening partnerships

Table of contents

1 Editorial

2 Mission



5 ESTRO School 40 LIVE COURSES 43 1. Wide range of topics proposed 43 2. 2019 School programme at a glance 44 PAGE

6 Policy


& partnerships 52 1. Collaboration with national societies that are related to radiation oncology 54 2. Strengthening worldwide collaborations with other radiation and oncology societies 55 3. Further enhancement of collaboration with patients and their advocates 57 4. Creation of partnerships with international agencies, organisations and associations 58 5. Creation of partnerships and new collaborative approaches with corporate members 58 6. Provision of advice to European bodies on radiation oncology policy 59

PRE-MEETING COURSES 1. Pre-meeting courses 46 2. Multidisciplinary tumour board sessions 46 47 1. FALCON, ESTRO’s contouring platform 47 2. Online delineation workshops 48 3. Delineation workshops at the ESTRO annual congress 49 4. Hands-on training: Mobility grants 50 46 E-LEARNING




4 Science

3 Membership 1. Profile of ESTRO Members




& dissemination 16 MEETINGS 18 1. ESTRO 38 18 2. ESTRO meets Asia 21 3. Joint events 22 4. Collaboration events 24 5. Endorsed events 25 6. Workshops 26


2. Structured and diversified membership categories 3. Membership categories under the spotlight


11 15

4. Main benefits of membership

7 Financial report 60 1. Treasurer’s report for 2019 62 2. ESTRO Audited Accounts 2018 63 PAGE 8 Annex 64 1. Governance & Constituent Bodies 66 2. Staff 69 3. Corporate members 70 4. Dual members 70 5. RTT Alliance 71 6. Institutional members 72 7. Green Journal 73 8. Awards 75 9. Newsletter 76 PAGE


28 28 30 33 34 34 35 37

1. The Green Journal 2. Open access journals 3. ESTRO newsletter







meets Asia. This is a truly interdisciplinarymeeting, where radiotherapists, radiation oncologists and physicists have a platform for discussion. As a basis for the congresses, workshops and networking activities, there is ESTRO’s family of journals. Read further in the report about the most popular articles and submission statistics. I am also proud to say that 2019 was a crucial year for a new impulse to ESTRO research, together with the European Organisation for Research and Treatment of Cancer (EORTC); in the frame of E2- RADIatE, a database and infrastructure tool for radiation oncology research, OligoCare is the first cohort hosted on the E2-RADIatE platform. It will collect data on the treatment of oligometastatic disease in lung, breast, prostate and colorectal cancer, 18 sites in 5 countries are participating. Strengthening the Profession Education is close to the heart of the Society’s members. The ESTRO School serves the community every year with 35 teaching courses, pre-meeting courses at the congress and contouring workshops, in and outside Europe. The ESTRO School is responding to the needs for skills and competencies that the ESTRO core curricula highlight. In this regard, I ampleased to say that in 2019 the fourth edition of the ESTRO Core Curriculum in Radiation Oncology was published and accepted by, the European Union of Medical Specialists (UEMS). This publication is of great value to the radiotherapy community as it continues to enable our trainees to develop adequate competencies. Strengthening Partnerships Collaboration is in the DNA of ESTRO; several agreements and memoranda of understanding foster partnership with a range of oncology societies, which have joined forces to advance multidisciplinary care and for the benefit of patients. Through 2019, ESTRO signed nine newmemoranda of understanding, establishing activities (education, science) and interchange (dual membership) with international radiotherapy andmultidisciplinary oncology societies. Through these links we are putting in action the partnership that the Vision so strongly recommends. Partnership also means mutual understanding, and ESTRO has been increasingly speaking with

The publication of the annual report of the European SocieTy for Radiotherapy and Oncology (ESTRO) is a welcome moment for the Society; it enables us to look back at the achievements of the previous year, in this case 2019. Looking at what ESTROhas accomplished and how the Society is growing provides uswith guidance for the next goals and ambitions; we hope that you enjoy reading it and that you find it informative and inspirational. Last year, 2019, was important because the ESTRO Vision 2030 – “Radiation oncology. Optimal health for all, together” – was published in Radiotherapy & Oncology. The new vision equips ESTRO with a strategic outlook for the future and defines the focus areas for the Society for the next decade. We encourage you to read the vision document if you haven’t done so yet, and we are sure that it will provide an interesting perspective onwhat every one of us, radiotherapy community members, is doing: contributing to the advancement of radiotherapy. The new vision statement is built around four concepts of core importance to ESTRO and its community: From Research to Practice; Strengthening the Profession; Strengthening the Society; Strengthening Partnerships. In this editorial, we turn the spotlight onto a few of the accomplishments that are driving us closer to accomplishment of Vision 2030: “Radiation oncology. Optimal health for all, together”. From Research to Practice Science is the pillar of our Society and its raison d’être, enabling the radiation oncology community to discuss research and new horizons. In 2019, the ESTRO scientific offer grew, providing a constantly growing offer of platforms for science dissemination and research. ESTRO38 in Milan drew 6633 attendees, making it the most well-attended ESTRO congress to date. The accompanying technical exhibition was also ESTRO’s largest: the congress is the hub for radiotherapy in Europe, enabling networking based on the latest science and technology. Similarly, we gathered with our colleagues over- seas in Singapore for the second edition of ESTRO




new partners and decision-makers. ESTRO and the ESTRO Cancer Foundation have published the White Paper “Radiotherapy: seizing the opportunity in cancer care”. The publication was presented during a policy forum at the European Parliament, to reach a new audience and highlight the importance of radiotherapy as a core pillar of cancer care. The paper is a very useful tool to raise awareness of the benefits of radiotherapy to external stakeholders, including the decision- makers, and I invite you to read it and share it with your colleagues. Strengthening the Society You, the members, are the heart and backbone of the Society. You are what make ESTRO work and live. In 2019 ESTRO counted nearly 7900 members from across the world. Membership has increased steadily over the years (+35% over the last five years). The ever-growingmembership is a testimony to the value of the activities that ESTRO offers, and also, we hope, to the pride felt by members in being part of the ESTRO family. There are new models for joining the ESTRO membership: now 19% of the membership is represented by institutional members, a fast- growing category. Institutes can subscribe and grant advantageous membership access to their radiotherapy teams. We would like to conclude by paying tribute to the dedication of all themembers who volunteer and commit to developing ESTRO activities, devoting their time and expertise, striving for optimal health for all. This is made possible thanks to the constant support of the ESTRO staff, our industry partners and other organisations that we collaborate with. 2019 was a very positive year. Now, reaching the Vision 2030 is a common effort; we need all members of the radiotherapy community to join forces. Thank you for being the drivers of the advancement of our Society.

The mission of ESTRO, a non-profit, scientific organisation, shall be to foster, in all its aspects, radiotherapy (also known as radiation oncology), clinical oncology and related subjects, including physics as applied to radiotherapy, radiation technology and radiobiology. Develop and promote standards of education in radiotherapy and clinical oncology Promote standards of practice in radiotherapy, clinical oncology and related subjects Stimulate the exchange of scientific knowledge in all related fields Strengthen the clinical specialty of radiotherapy and clinical oncology in relation to other specialties and professions involved in cancer management Encourage co-operation with international, regional and national societies and bodies representing radiotherapy, clinical oncology and related subjects Facilitate research and development in radiotherapy, clinical oncology and related subject To fulfil its mission ESTRO will:




Best wishes,

Umberto Ricardi ESTRO President (2018-2020)





With nearly 7900 radiation oncology professionals from across the world, the ESTRO membership is the heart of our organisation.



1. Profile of ESTRO Members

In 2019, ESTRO continued to attract new members and engage with existing members by giving them the resources and tools they need to successfully navigate a career in radiation oncology and its related fields. From support for professional development to even greater access to scientific information, the membership programme is focused on giving members more of what they need and want.

Breakdown of ESTRO members by specialty

7867 Members

5 Continents

51,54% Radiation oncologist 21,10% Medical physicist

12,46% RTTs - nurses - dosimetrists

1,24% Radiobiologist 6,58% Clinical oncologist

0,67% Industry representatives

6,40% Other medical and non-medical specialties

The ESTRO community extends far beyond these professional radiation oncology disciplines, taking in a wide range of other professions. This includes professionals from: other medical fields, such as surgeons, radiologists, medical oncologists, gynaecologists and urologists; and non-medical fields, such as public affairs specialists.

119 Countries



Geographical distribution

Top 10 countries

The Netherlands: 12%

Italy: 7% UK: 7%


Germany: 7% Belgium: 5% Canada: 4% Australia: 5% Spain: 4% France: 4%

75% Europe 8% Asia 9% Americas 6% Oceania

Switzerland: 4%

2% Africa and Middle East

Evolution of membership




Increase of 35% in five years

6,635 6,742









2. Structured and diversified membership categories



36,32% FULL (2841)

55 Institutes

35,62% Active (2857) €95 for one year and €170 for two consecutive years 0,5% Supporting ambassador (39) €250foroneyearand€450fortwoconsecutiveyears 0,2% Emeritus (16)



23,22% ASSOCIATE (1827) 17,52% Affiliate (1378) €55 5,21% In training (410) €75 0,5% Honorary (39)

19 National societies


38 Companies



3. Membership categories under the spotlight

1. Institutional membership


The institutional membership category is designed to help hospitals, clinics or other institutions providing radiotherapy and cancer treatment to develop and support their in-house radiotherapy and oncology professionals. This category allows institutes to purchase packages of individual memberships on behalf of their employees who can enjoy all the usual advantages of individual membership. The institutions themselves receive a range of benefits, including: A dedicated institutional webpage on the ESTRO website Free online job postings A monthly ESTRO Public Affairs newsletter sent exclusively to all institutional members An ESTRO institutional member logo, which can be used by the institute on their website, and in scientific presentations alongside their own logo A free exhibitor booth at the Communities Pavilion during the annual conference.

55 Institutes in total (see annex for list)

1496 Employees supported through this membership category

7 New institutional members in 2019

The 7 new institutional members in 2019 were:

France Centre Léon Bérard, Lyon Fontenay-aux-Roses Hungary University of Debrecen Clinic of Oncology

Italy InstituteHumanitasMirasole, Milano IRCCS Ospedale San Raffaele, Milano

United Kingdom North West Cancer Centre, University of Liverpool

The Netherlands Maastricht University


2. Supporting ambassador membership

The Ambassador Solidarity Fund enables sponsorship of educational grants, individual membership and registrations for ESTRO courses or events to support radiation oncology professionals from European countries facing more difficult economic situations.

This category is reserved for professionals in the field of radiation oncology who are strongly committed to the Society and who want to contribute to the Ambassador Solidarity Fund. The additional income generated goes to the Ambassador Solidarity Fund.

Educational grants awarded by the Ambassador Solidarity Fund helped:

72 Individuals signed up as supporting ambassadors

10 Participants to attend an ESTRO course



3. In-training members and young members

ESTRO also continues to develop its collaborations with European societies representing young members in order to encourage more young radiation oncology professionals to join the Society. ESTRO offers a dual membership tailored to these societies with a range of benefits.


3244 Young members in the Society (younger than 40 years old)

Breakdown of in-training members

The younger generation is the Society’s future and therefore it is essential for ESTRO to involve its young members in all of the Society’s activities.

410 individual in-training 1012 in-training members including:

250 young dual (who get the same benefits as an ‘in-training member) 352 institutional in-training

Illustrations of the involvement of the young community at ESTRO

The Young Corner in the ESTRO newsletter. There is a dedicated young section, coordinated by two young editors with news from young national societies, and young members sharing their experience through meetings or travel grant reports etc. The Young Track is an all-day session held during ESTRO’s annual Congress, which focuses specifically on topics of interest to young professionals.


4. Dual membership

In 2019 we concluded 3 new dual membership agreements with:

This category can be granted to individual members who benefitfromajointmembership agreement, signed on a case- by-case basis between ESTRO and a non–European society or a young national society active in the field of radiation oncology.

ACPSEM – Australasian College of Physical Scientists & Engineers in Medicine ISCORT – Israel Society for Medical Oncology and Radiotherapy SBRT – Brazilian Radiotherapy Society

5. Corporate members

Corporate members in 2019

Companies can opt for either ESTRO’s regular or gold corporate membership. Gold membership gives the right to a seat on the ESTRO corporate council, which works to facilitate collaboration and coordination between industry’s research and development activities, and the academic and scientific developments within ESTRO.

25 regular members 38 corporate members: 13 gold members



4. Main benefits of membership

ESTRO contributes to the day-to-day practice and career advancement of oncology professionals through the dissemination of the latest research findings and knowledge. ESTRO offers several levels of membership, with benefits tailored to the needs of each member and their level of involvement within the Society.


The full range of ESTRO membership benefits includes

Belonging to a community of around 7900 radiation oncology professionals

Online subscription to Radiotherapy & Oncology , the Society’s journal and member fees for publishing in the ESTRO OA journals

Networking opportunities and reduced fees for attending ESTRO teaching courses, online courses, workshops and conferences

Online access to scientific material, including event webcasts and delineation cases through the ESTRO e-library

Eligibility for grants, awards and ESTRO faculties and governance positions.





Science & Dissemination

ESTRO has a long track record of organising conferences, disseminating the latest findings and providing a platform for networking.


1. ESTRO 38 - The Annual Congress of the European SocieTy for Radiotherapy and Oncology 26-30 April 2019 | Milan, Italy MEETINGS


Breakdown per specialty

40.40% Radiation oncologist 26.90% Medical physicist 10.20% Clinical oncologist 11.00% RTTs - nurses 1.90% Computer scientist 1.40% Dosimetrist 0.80% RO Industry - Corporate 1.90% Radiobiologist

77% Participants 6,633 delegates:

23% Company delegates

0.20% Quality Manager 2.80% Other non-medical specialties 2.40% Other medical specialties

Evolution of participation to the ESTRO congress

Participants and Visitors Company Delegates

3rd ESTRO Forum: 4,933



ESTRO 35: 5,284



ESTRO 36: 5,860



ESTRO 37: 6,211



ESTRO 38: 6,633





Geographical distribution

Top 10 countries

Italy: 490

The Netherlands: 432

UK: 404

Germany: 279 France: 270

Spain: 166 USA: 171

Science & Dissemination

77,4% Europe

1,5% South and Central America 0,1% Africa 6,2% North America 12,6% Asia Pacific 2,2% Middle East and North Africa

Belgium: 161

Switzerland: 143 Denmark: 137

A comprehensive programme The state-of-the-art scientific programme of the Congress was developed by expert members of the various scientific advisory groups, who all worked on a voluntary basis. The programme covered all aspects of radiation oncology, featuring presentations from clinicians, medical physicists, radiobiologists, brachytherapists and radiation therapists.

Networking There were multiple opportunities to network at ESTRO 38, including in the 12,000m 2 exhibition space, the communities pavilion and start-up corner, and during social activities such as the welcome reception, poster awards ceremony, the Super Run and the social event.

Young programme A day was dedicated to ESTRO’s youngmembers. The programme included a teaching lecture, symposia and networking activities.

Many educational activities The educational programme included pre- meeting courses, teaching lectures, tumour board and contouring sessions. The educational programme is discussed in the School section of this report.




2,232 Abstracts

5,600.5 Sqm

123 Exhibitors

Main exhibition: 5516,5 Start-up corner: 84

Main exhibition: 95

170 Sessions

Start-ups: 14

Community pavilion: 14

311 Invited Speakers 203 Chairs 61 Co-chairs

Evolution of exhibition sqm at the ESTRO congress

3rd ESTRO Forum: 3,815

ESTRO 35: 4,428

ESTRO 36: 4,898

ESTRO 37: 5,401

ESTRO 38: 5,600.5

12 Commercial satellite symposia

Evolution of exhibitors at the ESTRO congress

3rd ESTRO Forum: 89

ESTRO 35: 103

418 Posters 1,067 E-posters

ESTRO 36: 123

ESTRO 37: 117

ESTRO 38: 123



2. ESTRO Meets Asia

6-8 December 2019 | Singapore

For a second time, the ESTRO Meets Asia congress had the objective to im- prove radiation oncology collaboration between Europe and Asia.

Breakdown per specialty

Science & Dissemination

39% Radiation oncologist

26% RTTs - nurses - dosimetrists

845 participants including 218 company representatives

44 countries

6% Clinical oncologist 19% Medical physicist

3% Dosimetrist

1% Radiobiologist 1% Industry representatives 5% Other medical and non-medical specialties

149 submitted abstracts

83% of the delegates came from Asia and Australia

Top 5 countries

63 sessions

72 speakers

Australia: 14% Singapore: 14% Thailand: 13% Malaysia: 8% Indonesia: 7%

29 Companies

70 posters


3. Joint events International Congress on Innovative Approaches in Head and Neck Oncology (ICHNO) 2019 14-16 March 2019 | Barcelona, Spain

The 7 th edition of the ICHNO provided a unique platform for the dissemination of the most relevant and cutting-edge science and innovation in the field of head and neck oncology. This biennial congress organised by ESTRO, the European Head and Neck Society (EHNS) and the European Society for Medical Oncology (ESMO) has been shaped to be a major international event in the promotion of multidisciplinary head and neck oncology.

624 delegates

Breakdown per specialty

24 speakers

36.84% Radiation oncologist 29.24% Clinical oncologist 1.17% RTTs - nurses - dosimetrists 2.34% Medical physicist 0.58% Computer scientist 0.29% Quality manager 28,65% Other medical and non-medical specialties 0.88% Radiobiologist

173 submitted abstracts


Top 10 countries

Spain: 61

UK: 56

France: 42

USA: 40

The Netherlands: 38

Germany: 26 Sweden: 23 Belgium: 29 Denmark: 34

624 delegates:

581 Participants

43 Exhibitors

Switzerland: 20



European Multidisciplinary Congress on Urological Cancers (EMUC) Implementing multidisciplinary strategies in genito-urinary cancers

14-19 November 2019 | Vienna, Austria Jointly organised by ESTRO, ESMO and EAU

This conference was jointly organised by ESTRO, the European Society for Medical Oncology (ESMO) and the European Association of Urology (EAU) EMUC’s mission is to improve the care of patients with urological malignancies by fostering education and knowledge exchange in urological oncology through regular international multidisciplinary meetings at which insights, best practices and prospects are discussed and examined in a comprehensive and critical manner by opinion leaders. ESTRO is represented in the Steering and Scientific Committees of this conference. As part of the meeting, ESTRO held a contouring workshop on ‘Pelvic nodal irradiation: Any news in the new era of imaging?’ that involved 15 participants.

Science & Dissemination

1215 delegates

102 speakers


223 EMUC abstracts submitted

223 submitted abstracts

167 accepted 56 rejected

Top 10 countries

Geographical breakdown of the participants

The Netherlands: 108

863 Europe

Spain: 86

17 South America 10 Oceania 50 Unknown 66 Africa 181 Asia 28 North America

Belgium: 69

Italy: 58

Austria: 46 Germany: 38 Greece: 47 UK: 52 Algeria: 34 Portugal: 56


4. Collaboration events European Lung Cancer Conference (ELCC) 2019 10-13 april 2019 | Geneva, Switzerland

Organised by the ESMO and IASLC with ESTRO, European Society of Thoracic Surgeons (ESTS) and the European Thoracic Oncology Platform (ETOP) as partners

The ELCC is a collaboration of the most important multidisciplinary societies that represent thoracic oncology specialists, working together to advance science, disseminate education and improve the practice of lung-cancer specialists worldwide. ELCC is now the point of reference in the field of thoracic malignancies. Since its inaugural session in 2008, it has secured its status as the premier meeting for professionals in the field. Medical oncologists, radiation oncologists, thoracic surgeons, respiratory physicians / pneumologists, interventional radiologists and pathologists all benefit from its comprehensive and stimulating programme.

European Cancer Organisation (ECCO) 2019 European cancer care across borders 12-14 September 2019 | Brussels, Belgium More than 350 leaders and stakeholders in cancer care from the fields of research, patient advocacy and public-private health-care came together at the ECCO 2019 European cancer summit. The summit theme looks to the 70:35 vision for cancer, which aims to achieve 70% average long-term survival for patients with cancer by 2035. In collaboration between member societies and the ECCO Patient Advisory Committee, it produced stimulating and illuminating sessions, and provided a platform for neglected aspects of the cancer policy debate to receive attention by: Debating leading-edge ideas in ways to improve cancer care; Trying to determine consensus resolutions for improving health-care systems;

The informative sessions explored border-busting themes such as the impact of artificial intelligence on various areas of cancer care, how to better provide cancer treatment across borders, the current status in respect of cancer patients being able to participate in clinical trials in other countries, and issues of professional specialisation and cross-border mobility of cancer experts. The summit also passed a powerful resolution regarding the elimination of cancers caused by the human papilloma virus (HPV) as a public health problem in Europe and a motion on the creation of an all-encompassing EU Cancer Mission.

Discussing and agreeing an action plan for the way forward to ensure that ideas translate into policies that will have impact on daily clinical practice.



5. Endorsed events

BGICC - Breast & Gynecological International Cancer Society (BGICS) The 16 th St.Gallen International Breast Cancer Conference 2019 RSS - The Radiosurgery Society- Annual Scientific Meeting

17-18 January 20-23 March 21-23 March 24-27 March 15-17 May 17-18 May 22-24 May 10-13 June 1-2 August 29-31 August 4-7 September 4-5 April 10-11 October 10-12 October 17-19 October 18-20 October 21-23 October 23-24 October 25-26 October 7-9 November 9-13 November 24 October 4-6 October

Cairo, Egypt

Vienna, Austria

San Diego, CA, USA

Predictive Models in External Beam Radiotherapy - Associazione Italiana di Fisica Medica AIFM

Naples, Italy

Amsterdam, The Netherlands The 14 th International Netherlands Cancer Institute Head and Neck Cancer Symposium

Science & Dissemination

Florence, Italy Dublin, Ireland Warsaw, Poland

EMSOS 2019

Annual Irish Stereotactic Radiosurgery and Stereotactic Ablative Radiotherapy Symposium

ESHO 2019

Bucharest, Romania

Oncology Summer School

Tehran, Iran

3 rd International Conference on Head and Neck Cancer Advanced Prostate Cancer Consensus Conference (APCCC) 2019

Basel, Switzerland

London, UK

London Breast meeting

Association of systemic treatments and radiation therapy in breast cancer: from evidence based to clinical practice

09-11 September Paris, France 20-21 September Mumbai, India 27-29 September Rimini, Italy

XVII Annual TMH Radiotherapy Practicum

XXIX AIRO National Congress

4 th international Slovenian Society of Radiographers SEETRO congress 2 nd Arab African International Cancer Congress (AAICC) 15 th Meet The Professor Advanced International Breast Cancer Course (AIBCC) The 29 th Annual Congress of the Romanian Society of Radiotherapy and Medical Oncology (RSRMO)

Ljubjana, Slovenia

Cairo, Egypt Padua, Italy

Cluj-Napoca, Romania

Leuven, Belgium

IFHNOS World Tour

29 th Residential Course on Modern Radiotherapy, time issues and new drugs

Rome, Italy

Paris, France Poznan, Poland Paris, France Athens, Greece


Young Scientists' Forum 2019


7 th Trends in H&N Oncology

Santiago de Chile, Chile


2 nd MD Anderson International meeting in Gastrointestinal Oncology. Current Practice and Controversies in the Era of Personalized Medicine Management of Breast & ColoRectal Cancer Kuwait Conference: Recent Updates International Oncology Leadership Conference by Association of Cancer Executives

13-15 November Madrid, Spain

14-16 November Kuwait City, Kuwait

17-19 November Antwerp, Belgium

21-22 November Milan, Italy

MIBIOC - The way of the microbiota in cancer

10-14 December Maastricht, The Netherlands Artificial Intelligence for Imaging


6. Workshops 3 rd Physics Workshop: Science in development 25-26 October 2019 | Budapest, Hungary This series of workshops offers opportunities beyond what ESTRO offers in educational and scientific meetings. It aims to facilitate scientific and professional networking opportunities within the ESTRO physics membership and for physicists working in other areas, and to create close interaction with developers in companies. This edition of the workshop considered five topics that had been selected by the ESTRO Physics Committee.

126 Participants

21 Countries represented

There were 20 to 40 participants registered in each group.

1 Company

RTT Workshop: Adaptation in a dynamic environment RTTs taking the future in own hands 8 November 2019 | Budapest, Hungary

39 Participants

The main topic of the first ESTRO RTTs’ workshop was how RTTs as professionals could adapt to the fast-changing technicalities of their dynamic work environment. This broke out into three topics that were addressed in parallel sessions. The three topics focused on education, image-guided radiotherapy (IGRT) and adaptive radiotherapy (ART), and the challenges of particle therapy. The format of the workshop was based on active discussion and involvement of all participants. Introductory lectures provided the basis for open discussion and interaction between participants who shared their own experiences and ideas. The workshop highlighted the challenges of RTTs continually developing daily practice.

13 Countries represented



7 th GEC-ESTRO Workshop 21-22 November 2019 | Budapest, Hungary

183 Participants

The Groupe Européen de Curiethérapie (GEC)-ESTRO annual workshop is now a hallmark platform for networking with the seven GEC-ESTRO working groups. The 7th GEC-ESTRO workshop covered different aspects of brachytherapy, with each working group covering a site-specific aspect of the speciality. The programme involved some parallel sessions as well as plenary. In one parallel session, four companies were given the chance to present some of their brachytherapy projects in development.

Science & Dissemination

32 Countries represented

4 Companies

7. Meetings by invitation Conference on experimental research in radiation oncology (CERRO) 19-26 January 2019 | Les Menuires, Trois Vallées, France The 34 th CERRO conference was held as per tradition in Les Menuires, Trois Vallées, France, in January. Participation is by invitation, and in this meeting there were 48 delegates from different disciplines in radiation oncology. Presentations on work in progress are the focus of the event, in order to stimulate discussions on innovative research. The meeting is also a platform for promoting collaboration and networking between members and for integrating young members into the Society.



1. The Green Journal

Radiotherapy & Oncology, known as the Green Journal, is the flagship publication in ESTRO’s family of journals. Led by editor-in-chief, Michael Bauman (Heidelberg, Germany), it covers all aspects of radiation oncology, publishing themed issues, editorials and correspondence, as well as original research and review articles.

Article transfer service to CtRO, PhiRO and TipsRO For manuscripts not selected for publication in Radiot herapy & Oncology, authors may be provided with the option of having their manuscript transferred to an ESTRO Open Access publication.

Manuscript submissions

Most popular articles published in 2019

Most downloaded articles from ScienceDirect, 2019

1. Selection of lymph node target volumes for definitive head and neck radiation therapy: a 2019 Update Biau J.,Lapeyre M.,Troussier I.,Budach W.,Giralt J.,Grau C.,Kazmierska J.,Langendijk J.A.,Ozsahin M.,O'Sullivan B.,Bourhis J.,Gregoire V. 2. MRI commissioning of 1.5T MR-linac systems - a multi- institutional study Tijssen R.H.N.,Philippens M.E.P.,Paulson E.S.,Glitzner M.,Chugh B.,Wetscherek A.,Dubec M.,Wang J.,van der Heide U.A.

350 Accepted papers 1613 submitted abstracts: 1261 Rejected 79 % REJECTION RATE



Evolution of manuscript submissions

Geographic distribution of accepted papers

Number of articles submitted


Science & Dissemination

2011 2012 2014 2014 2016 2016 2018 2018 2013 2015 2015 2017 2017 2019





194 Europe

52 Asia 87 North & Central America 16 Oceania


1 Africa

Original research



Letters to the editor and other

Short communication

Technical note

Breakdown of submissions types for 2019

Evolution – impact factor trend






1449 Original research

2 Editorial 61 Review


28 Letters to the editor and other 73 Short communication



0 Technical note



2. Open access journals

ESTRO will promote and publish journal(s) and, where appropriate, additional sup- plementary information of the highest scientific quality and through this approach set the existing and future standards for the speciality.

Breakdown of submissions types

Clinical & Translational Radiation Oncology (ctRO) Clinical & Translational Radiation Oncology (ctRO) is co-edited by Pierre Blanchard (Villejuif, France) and Daniel Zips (Tübingen, Germany). The editors-in-chief welcome research on all aspects of clinical and translational radiation oncology, particularly new developments in experimental radiobiology, clinical interventions and treatments. This includes imaging and biomarker studies with a clinical endpoint, as well as research results from data sciences, epidemiology and oncopolicy. ctRO is an Open Access journal. All members of ESTRO are eligible for a discounted fee and the fees vary depending on whether the manuscript is a full-length original research article, a short- format case report, technical note or short communication. All correspondence commenting on previously published work is published free of charge.

145 submitted articles:

65 Original research

10 Case report

13 Review

3 Short communication

51 Rejected 3 Other

Geographic distribution of accepted papers

Most popular articles published in 2019

Most downloaded articles from ScienceDirect, 2019 1. Adaptive radiotherapy: The Elekta Unity MR-linac concept Winkel, Dennis, Gijsbert H. Bol, Petra S. Kroon, Bram van Asselen, Sara S. Hackett, Anita M. Werensteijn-Honingh, Martijn PW Intven et al. 2. An in-silico quality assurance study of contouring target volumes in thoracic tumors within a cooperative group setting Elhalawani, Hesham, Baher Elgohari, Timothy A. Lin, Abdallah SR Mohamed, Thomas J. Fitzgerald, Fran Laurie, Kenneth Ulin et al 3. Technical design and concept of a 0.35 T MR-Linac Sebastian Klüter

88 accepted papers:

57 Europe

6 Asia 25 North & Central America



Physics & Imaging in Radiation Oncology (phiRO) Physics & Imaging in Radiation Oncology (phiRO) is edited by Ludvig Muren (Aarhus, Denmark) and Daniela Thorwarth (Tuebingen, Germany) and focuses onmedical physics and imaging in radiation oncology. The journal publishes original research articles, reviews, technical notes, short communications and correspondence. phiRO is an Open Access journal. All members of ESTRO are eligible for a discounted fee and the fees vary depending on whether the manuscript is a full-length original research article, a short- format case report, technical note or short communication. All correspondence commenting on previously published work is published free of charge.

Breakdown of submissions types

Science & Dissemination

1 Review 39 Full length articles 7 Short communication 62 submitted articles:

15 Rejected

Most popular articles

Geographic distribution of accepted papers

Most downloaded articles from ScienceDirect, 2019 1. Clinical implementation of magnetic resonances imaging guided adaptive radiotherapy for localized prostate cancer Tetar S.U.,Bruynzeel A.M.E.,Lagerwaard F.J.,Slotman B.J.,Bohoudi O.,Palacios M.A. 2. Cone beam computed tomography-based monitoring and management of target and organmotion during external beam radiotherapy in cervical cancer Jensen N.B.K.,Assenholt M.S.,Fokdal L.U.,Vestergaard A.,Schouboe A.,Kjaersgaard E.B.,Boejen A.,Nyvang L.,Lindegaard J.C.,Tanderup K.

48 accepted papers:

35 Europe

1 Asia 9 North & Central America

3 Oceania


Technical innovations & patient support in Radiation Oncology (tipsRO) Technical Innovations & Patient Support in Radiation Oncology (tipsRO)is edited by Sara Faithfull (Guildford, UK) and Michelle Leech (Dublin, Ireland). The journal offers radiation therapists, nurses and allied health professionals a forum for the publication of original research, case reports, practice development and health evaluation articles, reviews, short communications, technical notes and correspondence on topics including treatment planning and workflows, treatment delivery and verification, supportive care, psycho-oncology, education and training. tipsRO is an Open Access journal. All members of ESTRO are eligible for a discounted fee and the fees vary depending on whether the manuscript is a full-length original research article, a short-format case report, technical note or short communication. All correspondence commenting on previously published work is published free of charge. Most downloaded articles from ScienceDirect, 2019 1 . High frequency percussive ventilation for respiratory immobilization in radiotherapy Ina M. Sala, Girish B. Nair, Beverly Maurer, Thomas M. Guerrero 2. Implementation of state-of-the-art (chemo)radiation for advanced cervix cancer in the Netherlands: A quality improvement program Astrid A.C. De Leeuw, Remi A. Nout, Ruud G.H. Van Leeuwen, Anton Mans, Lia G. Verhoef, Ina Maria Jürgenliemk-Schulz 3. A pilot study of patient reported outcomes evaluating treatment related symptoms and quality of life for men receiving high dose rate brachytherapy combined with hypo-fractionated radiotherapy or hypo-fractionated radiotherapy alone for the treatment of localised prostate cancer Karen Crowther, Aidan Cole, Pat Shiels, Suneil Jain, Paul Shepherd, Darren Mitchell Most popular articles

Breakdown of submissions types

16 Full length articles 34 submitted articles:

1 Case report

1 Short communication

16 Other

Geographic distribution of accepted papers

22 accepted papers:

17 Europe

2 North & Central America

2 Oceania

1 Asia



3. ESTRO newsletter

The ESTRO newsletter provides a more informal space for members to read about the latest developments in the ra- dio-oncology field and its community.

In each issue expert editors, selected from the membership, curate contents for themed disciplinary ‘Corners’ or report on specific topics. The newsletter typically includes information on the latest advances in research and practice, interviews with key opinion leaders, conference findings, a selection of research papers and paper reviews.

Find all the articles on the ESTRO Website.

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Top five most read corners in 2019 (online) 1 . Read it before your patients

2 . ESTRO School 3 . Young ESTRO 4 . Physics 5 . RTT



The scientific engagement policy supports, facilitates, contributes to and/or drives research projects in line with the Society’s vision and relevance to its members. The scope of ESTRO involvement varies with the research topic, the type of research activity and the level of support requested. On the next pages are explanations of research activities in which ESTRO was involved in 2019. 1. EORTC-ESTRO Radiation Infrastructure for Europe (E 2 -RADIatE) The EORTC and ESTRO partnership endeavours to use this overarching platform to address the needs of the radiation oncology community in understanding the effectiveness of new and innovative treatments to improve the quality of life and survival of cancer patients.

E 2 -RADIatE is a joint ESTRO-European Organisation for the Research and Treatment of Cancer (EORTC) project that aims to develop a holistic database and infrastructure for radiation oncology research, in line with the ESTRO Vision 2030 and with the strategy of EORTC to conduct multidisciplinary research that covers all aspects of cancer management. The E 2 -RADIatEplatform is built tohost prospective data registries of “real-world” data on patients treated through radiotherapy. Radiation therapy suffers from a lack of collective knowledge on how treatments affect patients’ survival rates and qualities of life. For some cancers and indications, information is available through clinical trials, but formal data collection and data sharing is rather random especially with new treatments and techniques, and this may result in patients not receiving the best treatment for their cancer. The platformwill link diagnostic, radiation imaging, and treatment data to clinical outcomes for several cancers, thereby facilitating the analysis of new clinical indications treated by radiotherapy and the monitoring of new radiation techniques and technologies.

OligoCare is the first cohort hosted on the E 2 - RADIatE platform and will collect data on the treatment of oligometastatic disease in lung, breast, prostate and colorectal cancer. The objective of this data collection is to identify what factors (cancer, organ affected, staging, treatment) have an impact on overall survival of patients who develop oligometastatic disease at some point. By the end of 2019, nine sites in six European countries are recruiting and eight additional sites have been activated. In 2020, another 53 sites in 14 different countries will be activated. The aim is to have as many centres as possible engaging in this recruitment platform, for this cohort and/or for the many other cohorts planned for future years.

Formore details on activities of the E2-RADIatE please visit: E2RADIATE



2. European Particle Therapy Network (EPTN)

EPTN, a task force of ESTRO, was created to promote clinical and research collab- oration between the rapidly increasing numbers of European particle therapy (PT) centres and to ensure that PT be- came integrated in the overall radiation oncology community. Threemore newPT facilities have begun operating since the last meeting of the EPTN in London on 28 June: Denmark, The Netherlands and the UK. The EPTN took part in the scientific programme of ESTRO 38. EPTN was represented at the Particle Therapy Co-operative Groupmeeting (PTCOG-58), which was held in June 2019 in Manchester, UK. Highlights of the 2019 activities of the ESTRO working parties (WP): WP1: Clinical The main activities of working party 1 (WP1) are directed towards establishing the content of prospective data registries at a European level. The first consensus meeting of the WP took place on 5 September 2019. ESTRO and EORTC have set up a collaborative venture, EORTC-ESTRO Radiation Infrastructure for Europe or E2-RADIatE to form the EPTN prospective data registry. WP2: Dose assessment, quality assurance, dummy runs, technology inventory The WP2 held two workshops in 2019: one in March and the second in October. The focus of the workshops were (i) quality analysis (QA)/ equipment survey, (ii) reference and absolute dosimetry and (iii) dosimetry audits.

Fifth annual meeting on 9 April 2019

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44 Participants

33 institutions

13 European coun- tries represented

WP3: Education The WP conducted a survey to discover the needs for education and training of staff at European proton centres. The survey revealed the requirements for training in upcoming as well as in existing centres. To this end the WP is collaborating with the ESTRO school to incorporate particle therapy into the ESTRO core curriculum and the ESTRO School teaching courses through the format of workshops. WP4: Image guidance in particle therapy (IGPT) The aim of this WP is to gain insight into the current practice parameters of IGPT and to drive harmonisation through the establishment of body-site-specific consensus guidelines. All imaging workflow stages are covered by a multidisciplinary team of radiation oncologists, medical physicists and radiation therapists and in one case a radiologist. It is hoped to include vendors in some of the discussions. In 2019, the WP held one workshop to finalise site-specific surveys for launch. WP5: Treatment planning systems in particle therapy The WP has formulated several sub-groups to cover the most important aspects of treatment planning systems (TPS). For the sub-group that considers TPS specification, a collective list of specifications has been published on the ESTRO website to aid and inspire future proton centre managers in their procurement processes.

The TRS398 dosimetry document was approved.


WP6: Radiobiology and relative biological effectiveness The WP aims to form a network of clinical with radiobiological research facilities in order to facilitate research collaboration and standardisation of radiobiological experiments. It also intends to coordinate the research in order to obtain the necessary data of radiobiology of particle irradiation to support clinics. To this end it held its first workshop in February 2019. WP7 : Health economy The relevance of cost-effectiveness and costing data is clear, but the collection of real-world data is a big challenge. In collaboration with WP1, WP7 intends to design a simple form to collect health-economic data during and after proton therapy for the core data set of the OligoCare and ParticleCare projects using the E2-RADIatE platform within EORTC.

Formore details on activities of the EPTNplease visit:



3. Health Economics in Radiation Oncology (HERO)

The HERO cost accounting model and its use In 2019, several countries continued the exercise of using the HERO cost accounting tool, in order to gain insight on national resource requirements and costs of external beam radiotherapy. The dialogue with and the engagement of the national societies is of paramount importance to ensure that the HERO tool is a valuable support in decision making processes and negotiation. We describe the progress of the collaborating countries while more countries are showing interest in themodel and setting up task forces looking into the data collection. Belgium : an interdisciplinary group representing the Belgian national societies collected all the necessary input data to fill in the HERO model and reviewed two rounds of data output. Final model results were presented at the Annual meeting of the Belgian Society of Radiotherapy (BESTRO). Hungary : the implementation strategy of the model was presented at the Annual meeting of the Hungarian Society of Radiotherapy (HUSRO). A team of experts is finishing to validate the estimated outcomes Spain : in order to collect data input to fill in the HERO model, the Spanish radiation oncology community surveyed the patterns of care thanks to a large dedicated survey amongst SEOR tumour site-committees. The results of the survey, providing an overview of patterns of care, were presented at ESTRO 38 in Milan. France : the French national societies undertook a bottom-up input data collection applying the HERO tool in a representative sample of institutes fromeach of the three-hospital types (public, private and non-profit). The seven centers undertaking the tool application are now at different stages: some finalising the data collection and some validating them. United Kingdom : completing available national data sources, a multidisciplinary task force is now collecting remaining data inputs before starting the validation of the model results.

The focus on reimbursement systems Thanks to the collaboration of the HERO group and the National Societies, validating the data collected through a European survey on reimbursement system, an article providing a viewon the EU reimbursement systems have been published: “How public health services pay for radiotherapy in Europe: an ESTRO-HERO analysis of reimbursement”. This Policy Review assesses publicly funded radiotherapy reimbursement systems in Europe, looking also into the annual expenditure covering radiotherapy, calling for enhanced dialogue amongst scientific societies and policy makers, allowing radiation oncology services to follow evolving evidence. Yolande Lievens, Noémie Defourny, Julieta Corral, Chiara Gasparotto, Cai Grau, Josep Maria Borras, and ESTRO–HERO Consortium. How public health services pay for radiotherapy in Europe: an ESTRO–HERO analysis of reimbursement. The Lancet Oncology, Volume 21, Issue 1, 2020 , e42-e54. DOI: 10.1016/S1470- 2045(19)30794-6. Publications In the frame of the HERO project, the PhD investigating especially the cost of radiotherapy has been concluded. The PhD, “Radiotherapy in Europe: cost-modelling at national level”, starting with a state- of the art of the health economics of radiotherapy literature, describes the methodology of the Time-driven Activity- Based Costing (TD-ABC) modelling at national level for radiotherapy (also known as the ESTRO-HERO Tool) alongside with a practical application and discuss its public policies implications. Additional publications: Defourny N, Perrier L, Borras JM, Coffey M, Corral J, Hoozee S, van Loon J, Grau C, Lievens Y. National costs and resource requirements of external beam radiotherapy: a Time-Driven Activity-Based Costing model from the ESTRO- HERO project. Radiother Oncol 2019, 138(1) 187-194. DOI:10.1016/j.radonc.2019.06.015 Defourny N, Monten C, Perrier L, et al. Critical review and quality assessment of cost analyses in radiotherapy: how reliable are the data?

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