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The older analysis of simple tumor size at imaging has moved recently into a deeper analysis of imaging and its finest characteristics in the attempt to identify predictive biomarker of outcome radiomics. The routine use of computed tomography, magnetic resonance and often positron emission tomography associated to its complex anatomy and heterogeneity of HNSCC, allows different approach in radiomics analysis.
Sometimes and surprisingly, the features extracted are exported in different cancer such evidenced by Aert 1 biomarkers extracted from a lung cancer dataset and associated to oncological outcome, were translated and validated in independent datasets of head and neck cancer patients.
Many features often emerged from the analysis, and it s very difficult to understand real role and application of these plethora of data. An important contribute about this comes from Parmar s studies 2 the author tried to group in cluster the imaging biomarkers from the vast amount of extracted features and the results evidenced a significant association with patient survival and tumor stage.
Recently, the works of Leijenaar 3 provide a proof of concept that a radiomics analysis is able to derive molecular information from standard medical images in HPV positive HNSCC patients: a bridge between different aspect. Another recent field of interest was the analysis of molecular characteristics, in order to classified tumor not only and simply by histology, but also with the goal of a major precision in our treatment.
Gene expression profiles by microarrays or next-generation sequencing platforms have been widely used in developing biomarkers in HNSCC. These gene expression subtypes were correlated with biological features of tumors as well as the clinical outcome of patients. Linge 4 et al. Little biomarkers have been developed for predicting the clinical benefit of treatment.
The molecular and radiomics data today at our disposal are probably the way of future to improve the prediction on outcome. However the great variability and the lack of validation of various model used and the big amount of features potentially extracted, represent actually the real limit of this approach. Decoding tumour phenotype by noninvasive imaging using a quantitative radiomics approach. Development and validation of a radiomic signature to predict HPV p16 status from standard CT imaging: a multicenter study.
Clin Cancer Res. JAMA Oncol. It consists in extracting hundreds of quantitative features by an automated or semi-automated software. Radiomic relies on the hypothesis that mineable data can be extracted from medical images and provide additional information on gene protein and tumor phenotype and then used for patient care.
The real question could be: are we ready to adopt Radiogenomic in daily clinical practice? Probably no. There is an acute need for rigorous evaluation criteria and reporting guidelines which will allow establishing Radiogenomics as a firm scientific discipline in Radiation Oncology.
On the other hand, there is the need to improve the NTCP accuracy for the benefit of head and neck cancer patients. In fact, NTCP has several limitations. NTCP models are usually based on dose volume histograms, which are not ideal representations of 3-dimensional doses and assume that all the regions of an OAR have an equal functional importance, thus discarding organ specific spatial Information. Moreover, they do not take into account fraction dose variations, nor anatomical variations of the OAR and its dosimetric consequences during treatment.
Models taking into account more data such as 3-dimensional dose distribution in OARs, dependencies between the dose delivered at other OARs may enhance toxicity prediction. Dose-volume histograms of the whole organ at risk that treat the organ as a homogeneous entity are not a suitable basis for biology-based NTCP models.
In:Vaeth, JM et al, eds. Frontiers of radiation therapy and oncology VI. Baltimore: University Park Press. Use of normal tissue complication probability models in the clinic. Int J Radiat Oncol. In radiation oncology, the main goal is to raise the therapeutic efficacy of ionizing radiations without additional damage to the surrounding structures, thus increasing the differential effect between healthy and tumor tissues.
Nanoparticles NPs , in particular high atomicnumber z NPs, have been studied in the preclinical setting, showing a radio-sensitizing activity that exceed mere expected physical interaction and may underlie complex biological mechanisms of synergy such as increased ROS generation, cell cycle alteration, vascular damage and, as more recently highlighted, modulation of the immune response. Advances in nanotechnology manufacturing allow to increase the versatility of NPs by transferring new properties in order to enhance tumor selectivity, such as molecular targeting through 11 15 Programme chemical coating, or to favor association with other radiosensitizing agents such as hyperthermia, for exemple by employing magnetic NPs.
Despite encouraging pioneering trials and initial approval of NPs in association with radiotherapy in specific patient subsets, crucial criteria such as desirable physicochemical properties, route of administration, dosing and irradiation schedule still need to be defined in order to maximize the benefits of NPs in clinical practice.
Radiosensitization by gold nanoparticles: Will they ever make it to the clinic? Biological mechanisms of gold nanoparticle radiosensitization. Cancer Nanotechnol. Physical basis and biological mechanisms of gold nanoparticle radiosensitization. NBTXR3, a first-in-class radioenhancer hafnium oxide nanoparticle, plus radiotherapy versus radiotherapy alone in patients with locally advanced soft-tissue sarcoma Act.
Sarc : a multicentre, phase , randomised, controlled trial. Lancet Oncol Jul 8. Nanomaterials Basel May 6;8 5. Triggiani Radiation Oncology Department, Brescia University, Brescia, Italy Radiation Oncology RO is constantly evolving thanks to progress in radiobiological knowledge, but also advances in treatment options and dose delivery techniques. However, the latter do not necessarily result in a significant change in cure rates for radiotherapy RT , since multiple variables like tumor resistance, normal tissue toxicity and accurate radiation dose delivery may affect the efficacy of RT.
Nanotechnology has also emerged as a promising strategy and offers a number of unique features suited for applications in RO. Nanoparticles can be programmed to preferentially release therapeutic agents to tumor cells, owing to enhanced permeability and drug retention effect, hence a gain in safety and effectiveness from combination therapy. The preferential accumulation of nanoparticles in the tumor cells may lead to: a improved contrast enhancement for image-guided RT IGRT ; b tumorspecific delivery of chemotherapeutic agents or target therapies in combination with ionizing radiation; c increased local radiation dose using particles with high atomic numbers.
Different nano-platforms have been investigated for radiotherapeutic applications. Among them, gold nanoparticles were very promising due to their high X-ray absorption coefficient and the ease of their synthetic manipulation. The role of the emerging gold nanoparticles aided radiotherapy modalities was explored in this overview of the available clinical trials, with the aim to assess their establishment as more effective RT treatment options than the actual standard of care for cancer patients.
Despite tremendous successes in understanding their biology in the last decade, brain tumours remain the highest cause of mortality and morbidity rates in childhood and adolescence. Methods: In the field of pediatric neuro-oncology this has meant a great deal of diagnostic changes especially for medulloblastoma, other embryonal tumors and high-grade glioma patients but the impact on therapeutic decision is a modulation between still important clinical features of patients at different ages and these new acquirements.
Results: Some entities, now more precisely molecularly such as diffuse midline gliomas with histone H3. Other entities achieve a better cure rate but with severe late effects of disease and treatments and also require improvements of current treatments. We can only be successful in paediatric neuro-oncology when taking a multi-disciplinary approach ranging from preclinical teams through to all involved specialized clinical disciplines. Conclusions: An improved understanding of the molecular genetics, epigenetics, and cellular biology underpinning childhood brain tumours will potentially enable more effective and less toxic treatment strategies to be developed and implemented.
This could spare children from the severely detrimental consequences associated with conventional treatment protocols and improve the outlook for patients with currently incurable disease References 1. Childhood medulloblastoma. Childhood brain tumors: current management, biological insights, and future directions. Pediatric low-grade gliomas: next biologically driven steps. Scoccianti, M.
Teriaca, V. Lorenzetti, C. Caramia, L. Radiotherapy plays a fundamental role in the management of pediatric cancer, with the primary aim of achieving a high therapeutic ratio the highest probability of cure with the lowest risk of toxicity. Considering the risk of severe late effects mainly, neurocognitive deficits, hearing loss and hormonal deficiency for impairment of hypothalamic-pituitary axis , a major goal of pediatric cancer radiotherapy is to maintain or improve cancer cure rates, while decreasing treatment sequelae.
In addition the risk of second malignancy years after treatment may develop. Notably, the late effects of cranial irradiation are affected by a number of critical factors, including total and fractional dose, dose to organs at risk, use of other treatment modalities chemotherapy and surgery , use of other drugs steroids and antiepilectic drugs and patient age during brain irradiation. A variety of very conformal radiation therapy techniques with photons have been developed to try to limit the high radiation dose region to the tumor target.
The superiority of IMRT over conventional photon radiotherapy in terms of conformality and dose homogeneity was reported from dosimetric studies addressing different tumour sites. With these treatment modalities, new organs at risk hypothalamus, pituitary, hippocampus, scalp..
In addition, the advantages in terms of conformality of modern techniques make reirradiation a reliable option for recurrent pediatric brain tumors. By contrast, the possibility of sparing critical structures may be achieved with these techniques at the cost of increasing the low doses-bath with a potential risk of secondary carcinogenesis. Deep understanding of individual risk factors, normal tissues anatomy, functional brain regions and dose constraints has to be gained in order to take maximal benefit from technical solutions.
Prospective trials that monitor the late effects from modern photons treatment as well as protons treatments would be needed to confirm the expected reduction in long-term side effects. In addition, the collection of large data in multiinstitutional registries can help in improving evidences in terms of outcome of different technologies.
Schwartz CL. Long-term survivors of childhood cancer: the late effects of therapy. The Oncologist ;4: 17 Programme 2. Pediatric Radiation Oncology, Third Edition. Conformal radiation therapy for childhood CNS tumors. The Oncologist ;9; Paulino AC. Treatment strategies to reduce radiotherapy late effects in children. J Radiat Oncol ;2: Steinmeier T et al. Evolving techniques in paediatric oncology. Clin Onc ; Merchant et al. Barra Radioterapia infantile, Policlinico San Martino, Genova, Italy Radiation therapy is an important component of the multimodal approach to cancer treatment.
Continual, significant improvement has occurred in both photon and proton radiation therapy, with more precise dose conformity reduce radiation of adjacent normal tissues and associated risks. Late toxicities are most important in children and include diminished cognition, growth delay, bone deformation, endocrine dysfunction, and second malignancies.
This superior dosimetry can translate into clinical benefit with respect to the endpoints of toxicity, tumour control, quality of life, and patient survival. Expanding on IMRT, arc-based therapies have increasingly been utilized. An advantage of VAMAT Volumetric-modulated arc therapy , in addition to the excellent compliance of the dose and the use of noncoplanar planes, is the speed of treatment delivery.
This difference is particularly advantageous for paediatric patients, whose tolerance for treatments may be more limited than adult patients, and many of whom may require sedation while undergoing treatment. But this improvement can come at a cost of greater radiation exposure to non-targeted tissues when compared to less sophisticated techniques. An important assessment is the low-dose bath that these techniques may involve 5 and the daily use of IGRTs.
With doses of approximately 3 cgy per CBCT has the potential to substantially increase risk of late effects. It will be necessary to correct these technological advantages with prospective studies designed to reduce field size and the total dose. Currently many studies, on biological data, are studying a more accurately patient stratification and verifying which of these may receive a lower dose. Careful follow-up, quality controls will be necessary to assess whether advanced techniques can reduce late side effects and only then will it be possible to assess whether the RT with protons is higher.
Greenfield, B. Long-term disease control and toxicity outcomes following surgery and intensity modulated radiation therapy IMRT in pediatric craniopharyngioma. Oncol , , Nanda, R. Impact of craniospinal dose, boost volume, and neurologic complications on Intellectual outcome in patients wth Medulloblastoma.
Pediatric craniospinal irradiation with conventional technique or helical tomotherapy: impact of age and body volume on integral dose. Tumori Aug 3; 4 : Murphy, M. J, Balter, J. Balter, S. BenComo, J. Hess, Holly M. Benedict, J. Vaughan, and Allen M. Late effects of paediatric cerebral radiation therapy, cognitive dysfunction and endocrinopathy are the most frequent side effects of brain radiation therapy.
Depending on tumour location; auditive and visual impairment are also frequent. In an attempt to reduce unnecessary radiation dose to organs at risk for late effects, there has been a strong movement to utilize increasingly conformal modes of radiation therapy. Compared to photon therapy, PRT has a region of high dose deposition, with minimal dose delivery distal to the region of the Bragg Peak. This is in stark contrast to photons, which enter with high energies and deposit their dose not only throughout the tumor but also distal to the target As such, PRT allows significant reduction of the overall integral dose a child receives, potentially reducing risk of late side effects of such a dose bath.
With the advent of improved treatment modalities, our goal for treating pediatric malignancies should be not only to increase survival rates, but also quality of life for these survivors. PRT is an important modality that can help achieve such a profound goal. The utilization of PRT has been considered since as early as the s for the most common childhood CNS malignancies. It has maintained continued interest because it not only shows comparable clinical outcomes to photon therapy but also the dosimetric advantage of reducing dose to unintentionally irradiated tissues.
In addition of the survival literature data is in favour of neurocognitive, sensorial and endocrine benefits with protons compared to photons for all paediatric patients treated for brain tumours in a curative intend. The analyses showed that this achievement was mainly obtained through the reduction of late toxicity. Actually, reductions in intelligence quotient loss and growth hormone deficiency contributed to the greatest part of the cost savings and were the most important parameters for cost-effectiveness.
Many ongoing prospective clinical trials will allow evaluating the efficacy and toxicity of protontherapy. With increasing medical imaging tumour evaluation, one can also suggest that protontherapy could be also used for doseescalation on resistant tumours radioresistant clusters identified by molecular imaging without increased healthy tissue irradiation. The centers of protontherapy with children-dedicated equipment are needed to offer equal access to this therapy.
These centres should include general anaesthesia capacity, trained team and could be cost-efficient. Proton beam therapy for pediatric ependymoma. Proton radiotherapy for pediatric central nervous system ependymoma: clinical outcomes for 70 patients. Neuro Oncol ; Armstrong FD. Proton-beam radiation therapy and healthrelated quality of life in children with CNS tumors.
Gambacorta 1,2, L. Boldrini 1,2, G. Chiloiro 1,2, E. Meldolesi 1 1 Fondazione Policlinico Universitario A. In particular, Locally Advanced Rectal Cancer is usually treated with preoperative chemoradiation followed by surgery with or without postoperative chemotherapy according to risk factors related to initial staging and pathological tumor response. Oncological outcomes and response to preoperative treatment have a wide range of presentations and several factors need usually to be combined to predict tumor response and outcomes.
Among these factors, information coming from imaging play a fundamental role as predictors, also allowing adaptation of therapies throughout the treatment path of the patient. In this frame, Magnetic Resonance Imaging MRI has proven to be effective for rectal cancer staging and prognostic evaluation with the use of qualitative and functional information e.
Radiomics is a new-born science that aims to extract large amount of quantitative features from medical images. These features have the potential to disclose disease characteristics impossible to be appreciated by the human eye, useful for predicting prognosis and therapeutic response of tumors. The process of radiomic consists in 4 phases: image acquisition, image segmentation, features extraction and quantification, analysis and modelling. Recent experiences of radiomics in rectal cancer tested the feasibility of setting up predictive models of several clinical outcomes e.
Main goal of this talk is to present the meaning and the process of radiomics, giving an overview about the existing radiomics models for outcome prediction in patients affected by rectal cancer and discussing their role in supporting the choice of treatments that could be tailored to tumor phenotype, as coded by the radiomics analysis, and that can be used as an additional tool to identify patients eligible for an organ-preserving treatment. Different models will be presented, focusing both on long terms outcomes and pcr prediction, on staging MRI and radiomics values change during treatment delta radiomics with hybrid Magnetic Resonance guided Radiotherapy MRgRT machines.
Cusumano, N. Dinapoli, L. Boldrini et al. Dinapoli, B. Barbaro, R. Gatta et al. Magnetic Resonance, vendor-independent, intensity histogram analysis predicting pathological complete response after radiochemotherapy of rectal cancer International Journal of Radiation Oncology, Biology, Physics May 4. Boldrini, D. Cusumano, G. Chiloiro et al. Delta 15 19 Programme Radiomics for rectal cancer response prediction with hybrid 0.
Borghetti, A. Guerini, M. There is still no clear consensus concerning the role of consolidative thoracic radiotherapy TRT in this setting. Methods: We performed a review of the current literature regarding TRT in the treatment of stage IV SCLC, with particular emphasis on the analysis of survival, response rate and disease control results and on the influence of multiple risk factors.
Results: Although phase III CREST trial primary endpoint of OS improvement at 1 year was not met, subgroups analysis revealed an OS benefit in selected patients such as those with residual disease after chemotherapy, limited extrathoracic disease burden and good response after chemotherapy. Other prospective and retrospective studies also showed benefit in local control and survival.
Several factors might be considered to recommend TRT: fitness of the patient, extrathoracic tumour burden, initial bulky thoracic disease and response to chemotherapy. Conclusions: Albeit to date there is no consensus for the indications of TRT in stage IV SCLC, it should be considered for fit patients who responded to chemotherapy and bear limited residual extrathoracic tumor burden.
The brain, in fact, was assumed to be a pharmacologic sanctuary where subclinical metastases were protected from cytotoxic drugs by the blood brain barrier, and it was suggested that cranial irradiation might prevent the development of clinically evident brain metastases. Since then PCI had become the standard of care for many patients treated for small cell lung cancer.
The first meta-analysis supporting its use was published in particularly in patients with limited stage disease achieving a complete response. Currently, guidelines recommend low dose PCI, typically 25 Gray in 10 daily fractions in order to minimize late sequelae in longterm survivors.
The subsets of high risk patients such as the elderly 3 and patients who have been exposed to cisplatin 4 could develop significant brain radiation injury despite the conservative radiation prescriptions. Whether or not reduction of exposure of structures such as the hippocampus, applying modern technologies in meaningful benefit to patients, is the subject of ongoing trials. The most recent guidelines recommend that only patients who have responded to systemic treatment should be considered for PCI that should be administered only after the completion of all of the planned induction chemotherapy.
PCI should be offered to patients in whom asymptomatic small volume brain metastases have recently been excluded by volumetric MR imaging. The role of sparing hippocampus techniques to attempt to reduce neurological toxicities without a negative impact on local control is under investigation. Hansen HH. Should initial treatment of small cell carcinoma include systemic chemotherapy and brain irradiation? Prophylactic cranial irradiation overview collaborative group.
Radiotherapyof the brain in elderly patients. Sensorineural hearing lossafter radiotherapy and chemotherapy: a single blinded randomized study. Role of prophylactic cranial irradiation for elderly patients with limited-disease small-cell lung cancer: inverse probability of treatment weighting using propensity score.
J Radiat Res Jun 5. Is prophylactic cranial irradiation PCI needed in patients with extensive-stage small cell lung cancer showing complete response to first-line chemotherapy? The effects of prophylactic cranial irradiation versus control on survival of patients with extensive-stage small-cell lung cancer: a meta-analysis of 14 trials. Trodella, M. Fiore, I. Ridolfi, L. Trodella, S. The addition of radiotherapy to systemic treatment and the use of Prophylactic Cranial Irradiation PCI are some examples of these improvements in the localized and extended disease.
Despite these, SCLC continues to be one of the tumors with the worst prognosis on the global cancer scenario. Research by Radiation Oncologists and Medical Oncologists to improve clinical outcomes remains a challenge. This talk focuses on research that links improvements of clinical outcomes and new strategies in the treatment of SCLC.
This presentation highlights some of randomized controlled trials and real-life studies in patients affected by SCLC. Firstly, I will outline the research that has be done answering to questions still open high doses, extra-thorax irradiation, PCI with hippocampal sparing and then I will focus on the studies which provide evidence. The talk will also present interesting perspective trials we have to wait for the definitive results. There will be time for the audience to give their views at the end.
Campitelli 1, C. Nero 2, A. Santoro 3, R. Autorino 1, M. In clinical practice, radiation treatment of EC is decided according to a classification into prognostic risk groups derived from the well-known and historic PORTEC study 1 which takes in consideration the tumor type and grade, the stage and the presence of lymphovascular space invasion.
In , TCGA 2 analyzed the molecular genetic basis of EC development and defined four molecular subclasses, based on mutation burden and copy number alterations. As a consequence, Talhouk et al. Our lecture will focus on the previous studies and will discuss the classification system elaborated in our Institution, based on both clinico-pathologic and molecular findings, not only for the HIR EC patients, but also for low-intermediate and high risk EC patients.
This will lead to a better understanding of EC and hopefully it will improve individualization of treatment for each patient. Surgery and postoperative radiotherapy versus surgery alone for patients with stage-1 endometrial carcinoma: multicentre randomised trial. A clinically applicable molecular-based classification for endometrial cancers.
Confirmation of ProMisE: A simple, genomics-based clinical classifier for endometrial cancer. Wortman, T. Bosse, R. Nout, L. Lutgens, E. Westerveld, H. Slot, K. DeWinter, K. Verhoeven-Adema, V. Smit, C. Molecular-integrated risk profile to determine adjuvant 17 21 Programme radiotherapy in endometrial cancer: Evaluation of the pilot phase of the PORTEC- 4a trial. Vitali, F. Barbera, F. Frassine, S. Pedretti, D. Tomasini, M. Most patients are diagnosed at an early stage with a low risk of relapse.
However, there is a group of patients with a high risk of relapse and poor prognosis. The optimal adjuvant treatment for endometrial cancer remains poorly defined despite the prevalence of the disease and a large number of completed prospective studies. This ambiguity can be attributed to inadequate power in many of these studies due to heterogeneity in patient selection criteria, low recurrence rates in early stage endometrial cancer, and competing risk of death from other causes in women with endometrial cancer.
The most important prognostic factors identified in endometrial cancer are: FIGO stage, histological subtype, grade, depth of myometrial invasion, lymphovascular space invasion LVSI , and age. In the near future, the molecular advances could be used for outcome prediction and may aid in optimal distinction of the risk groups. Many Institutions try to provide evidence-based guidelines for adjuvant therapy in the treatment of endometrial cancer.
Despite the recent publication of randomized trials, the adjuvant treatment of endometrial cancer is still to be defined and there are many open questions about the best approach and the right timing. References Colombo, N. Alongi 1,2, N. Giaj-Levra 1, L. Nicosia 1, F. Recently, we are entering in a new technological era where onboard Magnetic Resonance Imaging guided-radiotherapy with hybrid MR-Linac accelerator systems will allow a direct tumor and surrounding organ at risk OAR real-time visualization.
Elekta Unity is a hybrid Linac with an on-board 1. This system received FDA approval in and it is now available for clinical use. The 1. More specifically, morphological imaging are used for adaptive strategies due to its high resolution with no additional ionizing radiation administration. Moreover, functional sequences could be relevant for potential predictive evaluation in the radiomics era.
A clinical protocol with the aim to define 1. A total number of patients will be recruited. The primary outcome is to collect real data of patients treated with 1. Conclusions: Hybrid 1. In October , the first oncological patient will receive a radiation treatment with 1.
MR-guidance in clinical reality: current treatment challenges and future perspectives. Radiat Oncol. Important technological and scientific developments have determined a considerable increase of patient exposure. The Directive highlights the necessity of justifying exposure and information offered to the patients.
The quality of programms developed and dealt with by the insurance companies is necessary, including the study of the risks of radiotherapy. A high level of competence is fundamental and a clear definiton of responsability of tasks taken out by all the professionals,doctors, fisicists and technicians for an adeguate protection of the patients who have to undergo a procedure of medical therapy. The State members ensure that the specialist in Medical Physics is responsible of the dosage, including the fisical measures for the rating of the doses administered to the patient and other people who are subject to medical exposure.
The final responsability of treatment and care remains that of the Radiotherapist. On the 25 May terminated the period of tollerance for the execution of GDPR on privacy which entered into force in Il Guarantor has adopted a uniform interpretation for healthcare.
Doctors can treat dates of their patients for treatment purposes without having to ask their consent, but must give complete information on what these dates will be used for. Necessity of consent for handling of data relative to an electronic health dossier or for consultation of referts on line. Disclosures have to be concise, transparent, comprehensible and easily attainable, written simply and clear and must contain information regarding, for example, those concerning the period of conservation of the dates.
The Authorities clarify that it is obligatory for all health operators to keep a register where all the activities of handling of data are listed of each patient. This document represents an essential element for the management of treatments and for an effective detection of those at greater risk, and for demonstrating the respect of the principle of accountability. It underlines that every project based on artificial intelligence should respect human dignity and the basic princple of lawfulness, fairness, specification of purpose, proportionality of the treatment, protection of dates right from the design, responsability, transparency, safety of dates and management of risks.
The lack of targeted therapies and the poor prognosis of patients with TNBC have fostered a major effort to discover actionable molecular targets to treat patients with these tumours. Massively parallel sequencing and other 'omics' technologies have revealed an unexpected level of heterogeneity of TNBCs and have led to the identification of potentially actionable molecular features in some TNBCs, such as germline DTEC mutations or 'BRCAness', the presence of the androgen receptor, and several rare genomic alterations.
A subgroup of TNBCs shows a high degree of tumourinfiltrating lymphocytes that also correlates with a lower risk of disease relapse and a higher likelihood of benefit from chemotherapy. Proof-of-principle studies with immune-checkpoint inhibitors in advanced-stage TNBC have yielded promising results, indicating the potential benefit of immunotherapy for patients with TNBC. The efficacy of programmed cell death protein 1 PD-1 blockade in metastatic triple-negative breast cancer TNBC is low, highlighting a need for strategies that render the tumor microenvironment more sensitive to PD-1 blockade.
Preclinical research has suggested immunomodulatory properties for chemotherapy and irradiation. Starting from this context, both pre-clinical and clinical data involving the combination of systemic therapy and radiotherapy for the treatment of TNBC will be addressed. Leonardi 1, A. Morr 1, M. Gerardi 1, S. Dicuonzo 1, D P. Rojas 1, M. Zerella 1,5, E. La Rocca 1,5, A. Ferrari 1, B. Bonanni 2, E. Munzone 3, R. Orecchia 4, B. The DNA damage induced by radiation or chemotherapeutic agents is magnified by a mutation in BRCA genes, which are either gatekeeper controlling cell cycling, proliferation and apoptosis and caretaker correcting errors and repairing DNA.
This synergism is known as synthetic lethality. Patients with oligometastases BC can benefit for ablative radiation treatment with the aim of achieving cure or prolonged survival, although the heterogeneity of the population and treatment schemes, the absence of randomized trials, has not yet pinpointed the best candidates. The effects of anthracyclines are based on destabilizing the DNA through intercalation while taxanes affect DNA repair cascade by targeting genomic instability.
Eribulin as first line or further-line setting significantly improved overall survival, especially in TNBCs. Understanding the alteration in tumor biology, especially the deficiency in DNA repair pathways, show a potential in future cancer therapy. Are we on the right way towards the exit from the labyrinth? Radioresistance in carcinoma of the breast. Breast Cancer Res. De Santis 1, C.
Giandini 1,2, M. Dispinzieri 1, R. Valdagni 3, S. Di Cosimo 4, L. Few and retrospective data are available in literature. Therefore, novel approaches to estimate clinical outcomes of HER2-targeted therapy are still needed. Plasma mirna or Circulating Tumor DNA gave promising evidence for further examination of response to anti-her2 agents.
A radiogenomic signature from the tumor and its environment, characterizing the response-associated HER2-E subtype, was identified in a recent study, applied to estimate response to anti-her2 therapy and then correlated with pathologic immune response on corresponding biopsy images. J Natl Cancer Inst Aug 1; 8. Clin Breast Cancer Feb;18 1 :ee Over the past decade, there has been an increasing use of radiotherapy RT for the treatment of liver metastases, and most often, in selected patients with oligometastases and limited liver involvement, ablative doses are deliv- 21 25 Programme ered to focal liver metastases, instead of whole-liver RT, aiming to improve time to progression and overall survival.
Multimodal imaging, accurate outlining of the gross tumor volume GTV and the clinical targeting volume CTV , advanced planning, IGRT, and motion management are then mandatory to improve the treatment accuracy. Extensive data has been published describing advantages and drawbacks of computed tomography CT or magnetic resonance imaging MRI for GTV delineation for liver metastases. Moreover, it remains questionable if microscopic tumor spread beyond the macroscopic tumor border or tumor capsule can reliably be evaluated with the current imaging methods.
Few studies have analyzed microextension characteristics in liver metastasis. In histopathologic specimens, liver metastases from colorectal cancer frequently show microscopic tumor spread beyond the tumor margin microsatellites and a safety margin should be applied to consider them. T1w or T2w MRI are recommend to ensure that the target volume contains macroscopic tumor, and also potentially tumor cell-baring inflammatory reaction or microsatellites.
Onkol Qian Y et al. Niespolo, S. Terrevazzi, A. Romeo, R. Colciago, M. Vajra, V. Tremolada, S. Arcangeli H. Gerardo, Monza, Italy Aims: Conventional radiotherapy in the treatment of liver lesions has historically played a marginal role due to the low tolerance of the whole liver to high radiation, while Stereotactic body radiotherapy SBRT has become an emerging treatment option for liver lesions in patients unsuitable for surgery We aimed to analyze the role of SBRT in the treatment of HCC and colorectal liver metastases.
Toxicity was focused on - although not limited to - the clinical and radiological appearance of the radiation-induced liver disease RILD. Interpretation of the reported survival rates is confounded by the significant heterogeneity in the included patients. Clinical features and dosimetric parameters should be tailored on candidates to SBRT in order to reduce the occurrence of adverse reactions. Conclusions: Several studies have demonstrated that SBRT for liver lesions is associated with optimal control rates and low toxicity profile uncommon G3 gastrointestinal toxicity , confirming that it may represent a safe and effective alternative local therapy for liver lesions.
Maddalo, P. Borghetti, M. Frassine, M. Buglione, S. The two main delivery methods with advanced motion management are 1 a free-breathing treatment with tumor tracking and 2 a linac-based gating in deep inspiration breath-hold DIBH with additional ultrasound monitoring. Less sophisticated techniques without advanced motion management are also reported in literature e.
Another option is to estimate the internal target motion from an external surrogate signal. However, the correlation between external and internal motion can be unstable. A hybrid solution combines external and sparse x-ray based internal monitoring systems and has recently been demonstrated for online clinical use with conventional linacs. A recent report investigating whether the tumor trailing on a MR-Linac can improve target coverage in liver stereotactic body radiation therapy SBRT showed promising results.
Andratschke N. Radiat Oncol ; pp Bertholet J. Radiother Oncol ; pp. Acta Oncol ; pp James J. Strahlenther Onkol ; pp Vogel L. In-vivo treatment accuracy analysis of active motion-compensated liver SBRT through registration of plan dose to post-therapeutic MRI-morphologic alterations. Meacci, V. Scotti, B. Agresti, M. Perna, L. Visani, V. Maragna, LP. Ciccone, G. Caramia, M.
Mariotti, D. Pezzulla, V. Salvestrini, G. Stocchi, B. Guerrieri, L. About one-third of patients with locally advanced stage III tumors are not subjected to surgery and for these patients the results in terms of long-term outcome are poor. The combination of radio- and chemotherapy has been recommended by the guidelines for the treatment of locally advanced diseases to reduce the risk of distant metastases and to maintain loco-regional control.
Combined chemotherapy and radiation therapy can be given simultaneously or sequentially. Although concomitant therapy is associated with increased toxicity, particularly at the esophageal level, several studies and meta-analyzes indicate that concurrent therapy is superior to sequential therapy in the treatment of this disease. Ferlay J et al. Cancer incidence and mortality patterns in Europe: estimates for 40 countries in Eur J Cancer 23 27 Programme ; 2.
Jemal A et al. Global cancer statistics. CA Cancer J Clin ; 3. Molina JR et al. Non-small cell lung cancer: epidemiology, risk factors, treatment, and survivorship. Mayo Clin Proc ; 4. Bayman N et al. How can we optimise concurrent chemoradiotherapy for inoperable stage III non-small cell lung cancer? Lung Cancer ; 5. Perez CA et al. Impact of irradiation technique and tumor extent in tumor control and survival of patients with unresectable non-oat cell carcinoma of the lung: report by the 6.
O Rourke N et al. Concurrent chemoradiotherapy in nonsmall cell lung cancer. Therapeutic management options for stage III non-small cell lung cancer. World J Clin Oncol. Curran WJ et al. Crino L et al. Early stage and locally advanced non-metastatic non-small-cell lung cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol ; Piperno 1, A. Jereckzek 1,2 1 Radiotherapy Division European Institute of Oncology Milan; 2 University of Milan, Italy Aims: A literature review of radio-chemotherapy associated cardiac toxicity studies in patients with locally advanced non small cell lung cancer treated with curative intent.
Results: Recently, there has been significant interest on cardiac dosimetry in the outcomes of radical treatment for NSCLC patients, especially after results of RTOG protocol and the reported excess of cardiac related deaths. Radiation-induced heart disease can manifest as a number of cardiac disorders such as myocardial ischemia, cardiomyopathies, conduction abnormalities, or pericarditis. Most of cardiac events occurred within years after treatment. In the past years many retrospective studies have been published on this topic.
More than dosimetric parameters are assessed as predictors of cardiotoxicity e. No clear association between any cardiac dose parameter and survival was identified in many studies; actually the relation between heart dose and cardiac mortality is more consistent. Of course preexisting cardiac disease is strongly correlated with cardiotoxicity and should be taken in consideration. Intersting data are known also on effect of immunosuppression and survival; heart dose is found to be related with immunosuppression in particular with neutrophil to lymphocyte ratio.
Moreover, heart dose is predictive for pulmonary toxicities, and the interplay between heart and lung must be better defined. There is a need to find dosimetric constraints not only for the whole heart but also for all the anatomic sub-structures pericardium, atria, ventricles, coronary arteries. The challenge is to find which dosimetric parameter is correlated with which cardiotoxicity ischemic, conduction etc. Also contouring of the heart is controversial and should be standardized.
The radiotherapy tec. Nowadays Intensity Modulated Radiation Therapy should always be considered the standard. Conclusions: Cardiotoxicity is a challenging and important topic and prospective analysis of dosimetric and clinical data should be performed. Eblan, Allison M.
J Clin Oncol Chia Ching Lee, Huili Zhenge, Yu Yang Soona et al: Association between radiation heart dosimetric parameters, myocardial infarct and overall survival in stage 3 non-small cell lung cancer treated with definitive thoracic radiotherapy Lung Cancer Christina K. A Systematic Review of the Literature.
However, these treatments are far to be considered curative since a non-negligible number of patients develop PSA failure after salvage treatments, either SRT 3 or salvage pelvic lymph-node dissection S-PLND. In this scenario, considering the lack of sensitivity of conventional radiological imaging for recurrent PCa, together with the presence of an accurate biomarker of early disease recurrence PSA serum level , the presence of a diagnostic tool able to precisely localize PCa recurrence would be crucial.
Thus, there is an unmet clinical need to improve target delineation in patients with potentially treatable PCa with early recurrence. The introduction of novel molecular imaging technologies significantly influenced the therapy management of recurrent PCa, leading to "imaging-guided" approaches. Despite there are strong evidences regarding the impact of PET imaging on patient management, there is a lack of data concerning the efficacy of PSMA-guided therapy to control the disease in the recurrent setting.
Whether or not PET-positive metastasis-directed therapy improves progression-free or overall survival remains unclear. Metastasis-directed therapy of regional and distant recurrences after curative treatment of prostate cancer: a systematic review of the literature.
Predicting the outcome of salvage radiation therapy for recurrent prostate cancer after radical prostatectomy. Eur Urol Aug 2. Eur Urol Oct Efficacy and impact on treatment strategy. Lancet Oncol Jul Eur Urol. Giannarini Urology Unit, Academic Medical Centre Santa Maria della Misericordia, Udine, Italy Image-informed metastasis-directed therapy is a novel and appealing treatment paradigm for patients with oligometastatic prostate cancer PCa [].
The aim of this lecture is to provide the latest evidence on the role of salvage lymph node dissection slnd in patients with nodal oligorecurrence of PCa after primary local treatment. Main limitations were: i retrospective design of single-centre series; ii inter-study heterogeneity in 25 29 Programme terms of study population, definition of progression, adjuvant treatment delivered and clinical endpoints; and iii lack of matched controls and long-term outcomes.
In a recent multi-centre retrospective study published after the previous meta-analysis and including patients submitted to slnd for oligorecurrent PCa, a novel risk stratification tool to predict early i. Independent predictors of early clinical recurrence were grade group 5 hazard ratio [HR] 2. Based on these factors, patients who would benefit the most from slnd from other patients who should be spared from surgery can be quite accurately identified.
In conclusion, a growing body of accumulated data suggests that slnd is a safe metastasis-directed therapy option in nodal oligorecurrence after primary local treatment. Winkler, Univ. Graz; E. Wolff, Univ. KI Wien. Zips DE To fulfill its purpose, ESTRO will promote innovation, research, and dissemina- tion of science through its congresses, special meetings, educational courses and publications.
More information on the and course programme on www. Information on the process More information on www. Royal College of Physicians and Surgeons of Canada. The Journal is one of the leading journals in the Radiation Oncology field. Oral communication Abstract is presented in one of the Proffered Papers sessions.
Certificates of attendance can also be These sessions take place in a designated room. During a Poster Discussion session, downloaded online until 3 months after the event. Poster authors are required to be on standby dur- ing the session in which their poster is being discussed, to answer any questions by CURRENCY the chair of the session and any participants.
Young scientists moving poster session These sessions take place in the Young Poster area. The presenting authors of Electronic poster stations located in the poster area will allow you to view the the selected posters in the same group will visit all the posters within each group, virtual displays at your leisure and to correspond with presenters or forward a along with the audience. At each poster, the presenting author is required to present presentation to a colleague or home office.
The A selection of the best posters will also be displayed in the poster area during the discussion is facilitated by two chairpersons. The poster reception and poster awards will take place in the poster area on Satur- Poster day 5 April, at All participants and company delegates are invited. Authors are required to display a poster on the designated poster panel. Posters are grouped by topic. An exhibition featuring equipment and medical publishers will be held in the Ex- Poster removal time: Posters should be removed on Tuesday, 8 April before hibition area.
The opening of the exhibition will be on Friday 4 April, at Any posters remaining after that time will be discarded. The exhibition will remain open between and until Monday 7 April. Authors are requested to be present next to their poster during the poster reception Entrance is free for all registered participants.
It will also be indicated in the official schedule, that posters can be viewed during lunch time on Sunday, 6 April and Monday, 7 April. E- posters will be avail- The Physics General Assembly will be held at There is no designated time slot for viewing.
April at Lunch will be available for purchase in the exhibi- tion area and is not included in the registration fee. The official language of the congress is English. No simultaneous translation will be provided. Saturday 5 April All participants and company delegates are invited to the poster reception and poster awards which will take place in the poster area at to Canaps and drinks Opening ceremony and welcome reception will be served while participants view more than posters of the best posters.
All participants and company delegates are invited to the official opening ceremony During the reception, 3 ESTRO awards of each will be handed out to the best which will be held in the auditorium on Friday, 4 April at The opening scored posters. Additional tickets for the V. The price D. Speakers are requested to Entertainment: Vienna Ballet bring their PowerPoint presentations to the Speaker Preview Room at least 3 hours prior to the start of the session or the day before if the session is planned in the early morning.
Please refer to the WIFI Satellite symposia section of this programme book for additional information. Wireless internet will be in the designated wifi area. Special thanks go to all the members of the scientific advisory groups, national organising committee members as well as the abstract reviewing committee for their valuable contribution to this congress.
Goitein CH D. Kogelnik AT Cobalt, carbon ions, nanotechnology and beyond B. Thwaites AU Real-time dose reconstruction during volumetric modulated arc therapy with Saturday, 5 April from Gupta IN Awardee: A. Hoeben NL Image guided adaptive radiotherapy - the paradigm of cervix cancer brachy- Sunday, 6 April from therapy R. She also collaborated with Ju- A Professor of Radiation Oncology since at the University of lie Denekamp and Ana Maria Rojas to investigate the radio-protective Burgundy and Cancer Centre GF Leclerc in Dijon France , he now effects of amifostine in normal tissues, and to compare this with any works since at the Institut Multidisciplinaire dOncologie of the potential protection of tumours.
Clinique de Genolier in Switzerland. In Amsterdam she contin- group and was among the founders of the Radiotherapy group in ued to investigate mechanisms of late radiation injury, particularly He remained secretary of this group for 6 years and president the long-term recovery potential of tissues and their tolerance to re- from to Another focus of the lab at that time was the interaction since , he acted as chairman of the Quality Assurance Commit- between radiation and chemotherapeutic drugs, especially cisplatin, tee , secretary-general , president , in tumours and normal tissues.
During the s Fiona set up a pre-clinical programme to investigate the clinical potential of photodynamic therapy PDT for treatment of Scientific achievements in EORTC include the pivotal trials on accel- small superficial tumours. This pre-clinical PDT programme resulted erated and hyperfractionated radiotherapy in head and neck cancers in the successful introduction of clinical PDT for oral cavity and skin and the pioneer methodogy and protocols of Quality Assurance in tumours and a dedicated PDT unit opened in December Radiation Oncology.
He participated actively to multidisciplinary re- The main focus of her lab was on radiation induced endothelial cell search in most solid tumours, in particular in head and neck, breast, and vascular damage in relation to late normal tissue injury.
Her male and female pelvic tumours. He contributed to the development latest projects investigated how radiation induces inflammatory and of brachytherapy and high energy equipments. He trained more than thrombotic changes in capillaries and large vessels and how these a hundred radiation-oncologists now active worldwide, delivered changes lead to progressive development of tissue damage and to presentations in scientific meetings and contributed to nearly atherosclerosis.
He became interested in the then unsolved problem in France. He was the first technique to reconstruct CT images. The tools developed, now routine but chemoradiation in digestive tract cancer. Biophysical modeling Michael Goitein together with Andrzej Niemierko developed models for the response to radiation of non-uniformly irradiated tumours.
The tumour model led to the revolutionary idea that the response of an inhomogeneously irradiated tumour was not, as was then sup- posed, dominated by the minimum tumour dose, and that a boost to just part of a tumour could increase the likelihood of tumour control. He investigated the impact on protons of tissue inhomogeneities and developed methods to compensate for them; developed treatment planning programmes for proton therapy of large-field treatments and treatments of ocular melanomas the latter is still widely used.
He has written on the ethics of randomised clinical trials of protons. Finally, Goitein led the effort to procure, design, build and commission a proton centre at the MGH. This was followed by a Fellowship in Radiotherapy at the M. There he ship in Experimental Radiotherapy; under Prof. Withers helped establish a large new Cancer Centre and a research facility He was awarded Board Certification in Therapeutic Radiology with two research linacs.
Medical Physics and Engineering, one of the UKs largest. Medical Physics, at Sydney University. From until his retirement in December , he was Head of the Institute of Radiotherapy and Radio-Oncology at the He has always held academic and clinical roles, with interests span- Landeskrankenanstalten Salzburg now Paracelsus Medical Univer- ning fundamental science to translational research. His career has sity. In , he initiated the integration of GRO in the AUSTRON- Career-long research interests have been in radiation dosimetry, Project, and became chairman of the Medical Advisory Board development and implementation of novel radiotherapy methods and MedAustron will start to treat patients with light ions next year in accuracy, QA and audit.
These have resulted in more than papers, Wiener Neustadt, Lower Austria. Red protocols, recommendations and guidelines in medical physics and Journal, Green Journal, Strahlentherapie und Onkologie. Krcher in Vienna, later in Salzburg.
He has been married to Melitta since David was awarded FRCR in for contributions to UK clinical oncology and was recently honoured by IOMP as one of 50 medical physicists to have made outstanding international contributions to the field. In virus HPV in head and neck cancer with specific interest on how , he became Full Professor and emeritus in She has published He collaborated on several books: De la radiobiologie la radi- several papers in this field, mainly based on previously conducted othrapie by M.
Tubiana and A. Wambersie, Collection M. Tubiana, J. Dutreix and A. Tubiana, in This research has been an important contribution to the understand- The neck cancer patients. Dutreix, G. Marinello and A. Wambersie in Hiraoka graduated from the Kyoto University School of Medicine in After Kyoto University Nanomedicine Merger Education Unit from to graduation in medicine in Mnster, Germany, he had training in sur- , and as first Director of Kyoto University Hospital Cancer Centre gery and internal medicine and became a diagnostic radiologist and from to He has been working continuously on imaging in radiotherapy since his habilitation on this topic in During these 4 years His major oncological areas of patient care and clinical research have he was dedicated to reinforcing the relation between JASTRO and been neutron therapy up to 93 , paediatrics, prostate and gynaecolo- ESTRO, including joint membership as well as the joint symposium gy.
He is currently President of the Japanese from He was part of the editorial board of oped in which he has been principal investigator since He is a leader of the ra- cal research in Hadron Therapy. Since he radiotherapy system Vero4DRT since , and realised tumour has been Chairman of the Council of Comprehensive Cancer Center tracking stereotactic radiation therapy with real-time monitoring for Vienna CCC and Coordinator of all tumour boards.
Richard Ptter lung tumour in , and tumour tracking IMRT for pancreas cancer is the author of over peer reviewed publications in scientific jour- in He clinical contributions, he was awarded as follows: has been continuously very involved in training and education with 1 Award of Minister of Economy, Trade and Industry for Develop- residents, PhD students and research fellows.
He subsequently served on the faculties models of magneto-hydrodynamic shocks in star forming interstellar of Memorial Sloan-Kettering, Cornell University Medical College and clouds, in collaboration with the Institut dAstrophysique Spatiale and Mount Sinai School of Medicine. In parallel with his Masters sor and University Chair of the Department of Radiation Oncology at studies, he also started a full-time job in IT outside academia. Thomas Ravkilde is currently working on a Ph. He has authored over scientific delivery for moving targets in radiotherapy with Ass.
His work has been the subject of several publications as ica by American Health magazine, a Readers Digest publication. Since he has served as Chief of the Clinical Radiation Oncol- Thomas is a keen adventure racer and can regularly be found in re- ogy Branch at the NCI, overseeing a portfolio of clinical research mote locations with a map, a backpack and a huge grin on his face. He grants within the Radiation Research Program as well as assisting the lives in a rural atmosphere in Haverslev, Denmark, with his wife, two Cancer Therapy Evaluation Program and the Coordinating Center for kids, dog, cat, horses and hens.
Clinical Trials with NCIs cooperative clinical trials groups pro- gramme. He also continues his work on improving cancer prevention and control worldwide. He then worked as senior registrar Bianca A. Hoeben cine department of a general hospital before starting her residency in in the department of radiation oncology, Tata Memorial Hospital, radiation oncology in , at the Radboud University Medical Centre Mumbai from August to July Here, he worked under in Nijmegen and the Arnhem Radiotherapy Institute.
He has participated in various multidisciplinary project concerning non-invasive characterisation of head and neck joint clinics, symposia, evidence based practice guideline sessions and cancer with PET imaging. Her clinical and pre-clinical research journal clubs. Special interest of the studies concerns Dr. Deepak Gupta then joined Medanta The Medicity hospital India, the potential application of molecular imaging for early treatment in August and is presently working here as attending consultant.
Here adaptation and prognostic purposes in head and neck cancer. The he has been involved in developing newer techniques of radiotherapy PhD project was guided by Dr J. Bussink, Prof. Kaanders treatment with special interest being Cyberknife fractionated radio- Radiation Oncology department , Prof. Oyen and Prof. Dr therapy and various aspects of motion management. Boerman Nuclear Medicine department. Deepak Gupta has around 20 national as well as international The research projects have arisen as a collaboration between the de- publications to his credit in various indexed journals.
During the following six months she worked Henrike Westerveld as a clinical doctor at the Department of Obstetrics and Gynaecology Viktoras Rudzianskas Viktoras Rudzianskas received his medical degree at the Medical at the Zaans Medical Centre, the Netherlands. University of Kaunas, Lithuania in In , after one year of clinical practice in general medicine, Viktoras Rudzianskas entered a Her scientific career started in with her PhD project regarding residency programme for radiotherapy and radiation oncology at the the search for genetic causes of male infertility.
During four years she Department of Radiotherapy, Lithuanian University of Health Sci- worked for many hours in the lab and learned all the ins-and-outs of ences, Kaunas, Lithuania. In she received her PhD degree for her thesis entitled Unraveling the genetics of spermatogenic fail- In his stayed as early stage research at the Department of Radia- ure.
Although it seemed to be a logical step to apply for a Residency tion Oncology at the University Hospital in Wurzburg, Germany in in Gynaecology, she decided to become a Radiation Oncologist. In August he passed his board examination and he was certified as In , she started her Residency at the Academical Medical Centre a medical specialist in the field of radiotherapy and radiation oncol- in Amsterdam, the Netherlands, under supervision of prof.
Caro ogy. Since then he has combined patients care and clinical research, Koning and later Dr Lukas Stalpers. During her Residency Henrike in which he focuses on multimodality treatment of head and neck became enthusiastic about brachytherapy. She applied for a grant cancer and reirradiation of recurrent squamous cell head and neck from the Dutch Cancer Association KWF for a two-years clinical cancer.
Between and he worked on his doctoral studies in fellowship in brachytherapy. Fortunately, her application was hon- high dose rate brachytherapy biomedical programme focusing on oured and after finishing her Residency in December , she started recurrence of head and neck cancer. There she became involved in the nas. During the remaining ment of Nuclear Medicine. Nowadays, she works as a staff member at the Academic Medical Cen- tre with brachytherapy and gynaecology as her main fields of interest.
Blanchard FR Session 2: Gastrointestinal and gynaecology Session 3: Prostate Learning Objectives: Knowledge in statistics and methodology is Session 4: Interdisciplinary necessary to understand scientific literature and to perform research.
Session 5: RTT This teaching lecture will give an overview on basic principles in statistics and methodology and will provide typical examples relevant for research in the field of radiotherapy and oncology. De Bari CH py techniques in clinical practice P. Stock AT D. Join clinical practice offers the distinct advantage of the certain technique this symposium to be part of the young ESTRO community, to get but is accompanied by new challenges and pitfalls in daily routine.
Specht DK T. Gauer DE Panellists: S. Alsner DK Organs at risk Learning Objectives: This session aims at providing a comprehen- Friday, 4 April from sive introduction into the complex topic of grant writing. In a first Repeated on Sunday, 6 April from presentation, current possibilities for European funding options will Chair: M. Guckenberger CH and S. Rivera FR be summarized.
In a second part of the session, tips and tricks neces- Panellists: S. Rivera FR , L. Kepka PL and U. Nestle DE sary for successful application to obtain a first individual grant will Administrator: D. Pasini IT be given. The session is especially devoted to young scientists in the field of radiotherapy which have not yet gained personal experience in grant writing. Hulshof NL and T. Marijnen NL Panellists: K.
Provide the participants with knowledge on how contouring is performed in different institutions and on the existing recommendations and guidelines. Beets-Tan NL strategy chosen Inter-comparison of the contours by the participants and by the experts Justification and comments.
Vordemark DE Surgeon P. Dubsky AT Medical oncologist E. Senkus PO Diagnostician T. Dinapoli IT Surgeon - H. Mehanna UK Medical oncologist - L. Licitra IT Diagnostician S. Combs DE and D. Verellen BE Course directors: C. Rdel DE and N. James GB Verellen BE and S. Combs DE Grard FR past-present-future - T. Verellen BE Role of induction-, concomitant, and adjuvant chemotherapy?
Beets-Tan NL - I. Stolberg US - P. Combs DE radical cystectomy? Levivier SE preservation versus radical surgery the urologists view - S. Lambin NL and D. Krysko BE Course directors: M. Alber DK and B. Vasquez-Osorio NL - D. Multhoff DE - K. Thorwarth DE T cells interactions - G. Boejen DK and B. Practical information - A. Speleers BE N ABS.
Short United Kingdom Chair: I. Baumann Germany SP relative seriality models? Malinen Norway Speaker: J. Schuffenhauer Germany Speaker: R. Classen Germany Moderator: V. Cellini Italy Speaker: H. Nilsson Sweden Panelist: D. Arnold Germany Panelist: R. In the early days the new medical discipline radiology covered both diagnostic and therapeutic applications and pioneering work was conducted at the esteemed Vienna School of Medicine in the early 20th century.
Cordes Germany SP of radiobiology and clinical radiotherapy. Moreover, the symposium will also address the impact of their impressive scientific results on modern clinical practice. In todays radiotherapy particle beams are intensively discussed and the number of facilities is steadily growing. The Austron project on neutron Symposium spallation pursued in the mid ies of the last millennium will be reviewed as it influenced todays ion Elective nodal irradiation: Head and neck, lung, oesophagus beam setting in Europe.
Bourhis Switzerland in the region that should be taken into consideration during the treatment of tumors located in this area. The lecture will try to address the question: should we Speaker: J. Kepka Poland, will discuss elective nodal irradiation in lung cancer. The second and clinical radiotherapy third part will be focusing on current evidences for and against its use in small cell lung cancer and Speaker: J.
Overgaard Denmark SP finally, in non-small cell lung cancer. Chair: P. Fastner Austria Speaker: R. Kepka Poland SP This session will focus on cell movement, migration, invasion and the epithelial-mesenchymal transi- tion. Various factors Speaker: M. Stuschke Germany SP related to these processes will be discussed, including autophagy, integrins, the actin machinery and the epidermal growth factor receptor. Chair: R. De Crevoisier France Speaker: V. The Radiation Speaker: P. The urologist point Speaker: J.
The Radiation Oncologist point of view using advanced elastic registration. Speaker: P. Speaker: O. Acosta France SP Subgroups of the Breast WG analyzed the procedure of target definition following closed cavity sur- gery as well in oncoplastic surgical procedures. Consensus meetings resulted in the preparation of surgery dependent recommendations on APBI target definition. Symposium The use of ultrasound US in brachytherapy is increasing.
Hypoxia is an important indicator of tumor aggressiveness and reduced sensitivity to radiotherapy. Chair: G. Kovcs Germany This session highlights established as well as experimental imaging techniques that are used to iden- Co-Chair: J. Dimopoulos Greece tify hypoxic regions in cancer. Various PET tracers are available that accumulate in hypoxic tissue.
With dynamic contrast-enhanced MRI the microvasculature is characterized. Hoskin United Kingdom SP cervical cancer. Finally, the potential of alternative MRI techniques will be discussed that more or less directly reveal the oxygenation status of tumors. A detailed understanding of the effects of non-uniform dose on OARs is indispensible to steer the dose optimization.
In this symposium we consider toxicity for OARs receiving heterogeneous dose. First, the use of dose surface maps for long-term rectal toxicity modelling is discussed. Next, a mechanistic view on the effects leading to complications follows, and a possible mechanistic NTCP model including volume effects is proposed. Brualla Germany , M. Rodriguez, L. Cozzi, A. Fogliata, W. Sauerwein, The session will be focused both on theoretical concepts and clinical implementation of ART strate- J.
Sempau PD gies. On-line ART approaches are guiding the advanced clinical daily practice, which will be described for different treatment sites. Fracchiolla Italy , S. Lorentini, M. Schwarz PD Chair: F. Moura Portugal Co-Chair: H. Moghaddasi Australia , E. Bezak, W. Chabert France , D. Lazaro, E. Barat, T. Dautremer, T. Montagu, Speaker: I. Madani Belgium SP M. Agelou, P. Dupuis, F. Gassa, L. Pasini Italy SP using real patient geometries Y. Ma Canada , F.
Lacroix, M. Lavalle, L. Spezi United Kingdom Chair: R. Schmid Austria Chair: I. Hug Australia , M. Ebert, K. Warrener, N. Suchowerska, P. Liu, marker of tumor hypoxia A. Ralston, D. McKenzie, R. Woodward PD B. Gallez Belgium , F. Colliez, M. Safronova, J. Magat, T. Duprez, B. Francescon Italy , S.
Beddar, I. Das PD planning for patients with esophageal cancer C. Muijs The Netherlands , J. Beukema, D. Woutersen, V. Van der Jagt, J. Pruim, G. Hospers, H. Groen, J. Langendijk OC D. Arnesen Norway , T. Hellebust, E. Malinen OC E. Alber Denmark , N. Schwenzer, H. Schmidt, A. Mller, D. Thorwarth OC R. Mkacher France , T.
Girinsky, B. Colicchio, M. Ricoul, L. Heidingsfelder, J. Bourhis, S. Koscielny, J. Paul, P. Carde, L. Kager The Netherlands , F. Koetsveld, M. Bloemers, P. Lartigau France M. Intven The Netherlands , O. Reerink, M. Philippens OC Chair: N. Lyhne Denmark , H. Primdahl, C. Kristensen, E. Andersen, patients J. Johansen, L. Andersen, J. Evensen, J. Vozenin Switzerland analysis according to patient characteristics P. Blanchard France , B.
Lacas, J. Bourhis, A. Trotti, B. Nankiwell, J. Langendijk, J. Overgaard, J. Pignon OC and mitochondrial dysfunction F. Paris France , A. Lafargue, C. Pecqueur, F. Nevens Belgium , M. Lambrecht, G. Duprez, J. Van den Weyngaert, N. Platteaux, Y. Geussens, M. Voordeckers, induced pneumonitis and pulmonary fibrosis W.
De Neve, S. Nuyts OC D. Van Berlo The Netherlands , A. Gasparini, M. Verheij, J. Sonke, C. Van der Laan The Netherlands , R. Steenbakkers, H. Bijl, S. Van der Veen The Netherlands , H. Faber, S. Brandenburg, A. Van der Schaaf, O. Chouvalova, J. Vemer-van den Hoek, J. Langendijk, R.
Coppes, P. Van Luijk OC J. Van der Veen, H. Faber, P. Van Luijk, R. Alterio Italy , D. Ciardo, A. Argenone, O. Caspiani, R. Micera, M. Ruo Redda, E. Russi, E. Bianchi, E. Orlandi, R. Fachal Spain , A. Gomez-Caamao, G. Barnett, S.
Kerns, B. West, A. Dunning, A. Bje Denmark , S. Dalton, H. De Ruysscher Belgium Chair: C. Salembier Belgium Chair: M. Rajer Slovenia Chair: A. Van Houtte Belgium , M. Paesmans, P. Garrido, H. Choy, P. Fournel, P. Hoskin United Kingdom , P. King, J. Wylie, A.
Lydon, T. Sreenivasan, J. Van Meerbeeck, T. Berghmans, J. Sculier OC A. Bahl, A. Henry, I. Ahmed, C. Elwell, C. Dekker The Netherlands , S. Vinod, L. Holloway, A. George, G. Goozee, M. Beaulieu Canada , P. Desprs, A.
Martin, W. Foster, G. Delaney, D. Oberije, P. Lambin, D. Thwaites OC E. Peeters Belgium , C. Dooms, J. Vansteenkiste, H. Decaluwe, P. De Leyn, I. Spadinger, W. Morris Canada , J. Chu, M. Afsari Golshan, M. Keyes OC K. Nackaerts, W. De Wever, C. Deroose, D. Wojcieszek Poland , M. Fijalkowski, S. Kellas-Sleczka, B. Bialas OC A. Bradshaw United Kingdom , C. Esler, A. Roy, E. Toy, J. Lester, J. Kinsman, P. Atherton, C. Knox, G.
Walker, M. Peters The Netherlands , M. Maenhout, J. Van der Voort van Zyp, nonresected non-small cell lung cancer M. Moerland, M. Moman, U. Van der Heide, L. Steuten, K. Wurstbauer Austria , H. Deutschmann, K. Dagn, F. Zehentmayr, J. Battermann, M. Van Deursen, M. Van Vulpen OC C. Fussl, P. Kopp, P. Porsch, B. Maurer, M. Studnicka, F. Oismueller Austria , K. Poljanc, C. Somay, S. Schuch, E. Troost The Netherlands , B. Reymen, A. Van Baardwijk, M.
Rauchenwald, S. Madersbacher, R. Hawliczek OC S. Wanders, F. Hoebers, E. Bloemen-van Gurp, K. Smits, A. Dingemans, P. Toftegaard Denmark , W. Fledelius, D. Seghers, M. Huber, E. S Worm, Chair: W. Tom USA U.
V Elstrm, P. Verhaart The Netherlands , R. Pellicer, A. Van der Lugt, S. Lee Canada , N. Ybarra, K. Jeyaseelan, S. Faria, N. Kopek, M. Vallieres, M. Paulides, G. Kotek OC I. Winter Germany , S. Leibfarth, D. Paulus, H. Quick, S. Gatidis, A. Cole United Kingdom , C. McGarry, S. McMahon, H. Schmidt, N. Schwenzer, D.
Zips, D. Thorwarth OC K.
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