Abstract book - ESTRO meets Asia

S1 ESTRO meets Asia 2018

Friday 7 December 2018

replaced the Electronic Portal Imaging Device as the gold standard for precise and accurate patient positioning. Besides that, the Conebeam-CT gave us insight in flaws in Portal Imaging, for instance in underestimating set-up inaccuracies in case of breast cancer imaging. At a later stage, the value of more detailed soft-tissue became more prominent and opened the door for adaptive strategies based on Conebeam-CT. On one hand, 3D imaging has given us the ability to monitor patients' anatomy and pathology during treatment. This gave a better insight on the anatomical dynamics over the course of treatment, especially clinically relevant when it comes treatment in the thoracic region. In the end, it also led to the creation of a protocol on how to deal with these changes during treatment. Another development that was enabled by 3D volumetric imaging was the introduction of so called plan of the day protocols. This protocol allows us to deal with changes that are hard to control, mainly for changes caused by the bladder. In the treatment preparation phase, two CT's are performed with a fully filled as well as an empty bladder. During planning target and OAR structures are delineated. Using inter- and extrapolation algorithms more potential bladder filling situations are virtually generated, finally leading to 3 to 5 treatment plans. On the treatment unit the optimal plan is selected based on images made with Conebeam-CT. Different studies have showed a successful reduction of dose in the surrounding organs at risk in the treatment of bladder and cervical cancer. More changes are about to occur in near future. All these paradigm shifts impact the daily work of the Radiation TherapisT (RTT). RTTs need continuously update their knowledge and competences to be able to optimally perform in a quickly changing environment. SP-004 Introducing advanced technologies: the reality P. Ravindran 1 1 Christian Medical College Hospital, Radiotherapy, Vellore, India Abstract text Background: There is considerable cancer burden in low- and middle-income countries (LMIC). Radiotherapy is a cost-effective cancer treatment modality that offers the potential for cure, control, and palliation of disease in greater than 50% of patients. As LMICs have lesser access to newer technologies in Radiation therapy, implementation of latest technologies in these countries could be a challenging task. Aim : The purpose of this presentation is to share the experiences gained by involving in the establishment of new radiation therapy technologies in a few Low and Middle-income countries, discuss the issues and the methods to address them. Methods : During the last decade, the author had the opportunity to visit a few of the LMICs either to help in establishing advanced radiotherapy technology or to participate in the training programs in radiation therapy as a faculty member. In addition to his involvement in establishing new technologies in India, he was involved in commissioning a Treatment planning system for Cobalt unit at Ulaanbaatar, Mongolia, a linear accelerator at Myanmar, state of the art linear accelerators at a new Radiotherapy centre at Brunei Darussalam, and a couple of Radiation therapy Physics training programs at Bangladesh. During these assignments he had the opportunity to train the staff on the safe use of the advanced technologies.

Teaching lecture: DNA damage and repair, chromosome damage, checkpoints

SP-001 DNA damage and repair, chromosome damage, checkpoints A.Potter 1 1 Royal Adelaide Hospital, Radiation Oncology Department, Adelaide, Australia

Abstract not received

Teaching lecture: From 2D to IMRT: technology, teartment planning, delivery and QA

SP-002 From 2D to 3DCRT to IMRT T. Wong 1 1 Seattle Proton Therapy Center, Medical Physics, Seattle, USA Abstract text Radiation therapy is one of the most technologically driven treatment modalities for cancer patients. Tremendous advances in treatment planning and delivery technology have improved radiation dose conformity to target volumes while sparing critical healthy tissues. We have evolved from basic 2-dimensional (2D) radiation therapy of the 1980s to 3D conformal radiation therapy (3DCRT) of the 1990s, and eventually to modern intensity modulated radiation therapy (IMRT). Improvement in computational hardware of linear accelerators and software of treatment planning systems now supports modulation of the number of treatment fields, the intensity of radiation within each field, and its dynamically controlled shape in IMRT. By expanding our ability to sculpt radiation dose around target volumes, IMRT has increased the therapeutic window through safe dose escalation to improve treatment outcomes in certain disease sites. Whereas the evolution from 2D to IMRT in conventional radiation therapy took place over the course of 20 years, we have observed accelerated development and deployment of proton beam therapy (PBT) in the past several years, moving from simple passive-scattered treatment delivery to sophisticated image-guided pencil beam scanning (PBS) treatment delivery across a variety of clinical platforms. This presentation will review the technological advancements in radiation therapy from 2D to 3DCRT to IMRT. It will highlight improved treatment delivery with multileaf collimators and linear accelerators, improved target definition with computed tomography (CT) and multimodality imaging, and enhanced dose calculation engines and optimization algorithms during inverse treatment planning. The rapid evolution of PBT, from passive scattering to uniform scanning and PBS techniques, will also be discussed. SP-003 Changing paradigms in RTT practice from 2D to ART M. Kamphuis 1 1 Academic Medical Center, Academic Physics , Amsterdam, The Netherlands Abstract text Since the introduction of Conebeam-CT in 2003, the use of volumetric imaging has become more and more common. First, benefits were mainly seen in an improved accuracy of image registration. Conebeam-CT