ESTRO 2020 Abstract Book

Translatingresearchand partnershipintooptimal health ONLINECONGRESS 28November-1December2020

Radiotherapy &Oncology Journal of the European SocieTy for Radiotherapy and Oncology

Volume 152 Supplement 1 (2020)

Radiotherapy & Oncology is available online: For ESTRO members: http://www.thegreenjournal.com For institutional libraries: http://www.sciencedirect.com

Amsterdam • Boston • London • New York • Oxford • Paris • Philadelphia • San Diego • St. Louis

International Standard Serial Number 0167-8140

© 2020 Elsevier B.V. All rights reserved.

This journal and the individual contributions contained in it are protected under copyright by Elsevier B.V., and the following terms and conditions apply to their use: Photocopying Single photocopies of single articles may be made for personal use as allowed by national copyright laws. Permission of the Publisher and payment of a fee is required for all other photocopying, including multiple or systematic copying, copying for advertising or promotional purposes, resale, and all forms of document delivery. Special rates are available for educational institutions that wish to make photocopies for non-profit educational classroom use. For information on how to seek permission visit www.elsevier.com/permissions or call: (+44) 1865 843830 (UK)/(+1) 215 239 3804 (USA). Derivative Works Subscribers may reproduce tables of contents or prepare lists of articles including abstracts for internal circulation within their institutions. Permission of the Publisher is required for resale or distribution outside the institution. Permission of the Publisher is required for all other derivative works, including compilations and translations (please consult www. elsevier.com/permissions). Electronic Storage or Usage Permission of the Publisher is required to store or use electronically any material contained in this journal, including any article or part of an article (please consult www.elsevier.com/permissions). Except as outlined above, no part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without prior written permission of the Publisher. Notice No responsibility is assumed by the Publisher for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions or ideas contained in the material herein. Because of rapid advances in the medical sciences, in particular, independent verification of diagnoses and drug dosages should be made. Although all advertising material is expected to conform to ethical (medical) standards, inclusion in this publication does not constitute a guarantee or endorsement of the quality or value of such product or of the claims made of it by its manufacturer.

Orders, claims, and journal inquiries: Please visit our Support Hub page https://service.elsevier.com for assistance.

Funding Body Agreements and Policies Elsevier has established agreements and developed policies to allow authors whose articles appear in journals published by Elsevier, to comply with potential manuscript archiving requirements as specified as conditions of their grant awards. To learn more about existing agreements and policies please visit http://www.elsevier.com/fundingbodies

Available online at www.sciencedirect.com ScienceDirect

ESTRO 2020 ONLINE CONGRESS 28 November - 1 December 2020 Table of contents

SATURDAY 28 NOVEMBER 2020

Teaching Lecture The ultimate truth on how to get your paper published in an ESTRO journal ..................................................... (Abs. 1-4) Differential biological effects of photon and particle irradiation: experimental highlights and clinical impact... (Abs. 5) Fractionation in prostate cancer radiotherapy . ......................................................................................................... (Abs. 6) Which organs should be spared to achieve optimal dose distribution in thoracic tumours? ............................... (Abs. 7) Do’s and don’ts in automated treatment planning – optimising conditions and expectations ............................. (Abs. 8) IAEA guide on Radiation Protection and Safety in Medical Uses of Ionising Radiation .......................................... (Abs. 9) The evolution of RTT leadership in radiation oncology ........................................................................................... (Abs. 10) Symposium Management of complex skin targets-what is the optimal radiation technique? . ......................................... (Abs. 11-14) Cutting-edge genomics in radiation oncology .................................................................................................... (Abs. 15-18) Debate This house believes that Elective nodal radiotherapy should be performed for high risk prostate cancer .....(Abs. 19-22) This house believes that upfront radiotherapy is mandatory in patients with brain mets even in the era of immunotherapy ...................................................................................................................... (Abs. 23-26) Symposium Where automation can or cannot help the medical physicist .......................................................................... (Abs. 27-29) Joint Symposium ESTRO-AAPM: The future of Medical Physics in Radiation Oncology ............................................................... (Abs. 30-34) Symposium RTT leadership in radiation oncology................................................................................................................... (Abs. 35-37) Poster Highlights Poster highlights 1 CL: Head & Neck ................................................................................................................... (Abs. 38-44) Poster highlights 2 PH: Dosimetry and detectors .............................................................................................. (Abs. 45-50) Poster discussion CL: Head and neck 1 .............................................................................................................................................. (Abs. 51-55) CL: Prostate 1 ......................................................................................................................................................... (Abs. 56-61) Radiobiology .......................................................................................................................................................... (Abs. 62-67) RTT 1 ....................................................................................................................................................................... (Abs. 68-73) Proffered Papers Proffered papers 1: HSR HERO . ........................................................................................................................... (Abs. 74-79) Proffered papers 2: Interactions between radiation and the immune response ........................................... (Abs. 80-85) Proffered papers 3: Sarcoma ............................................................................................................................... (Abs. 86-90) Proffered papers 4: CNS ....................................................................................................................................... (Abs. 91-95) Proffered papers 5: Analysis for toxicity and outcome ................................................................................... (Abs. 96-101) Proffered papers 6: Novel treatment planning strategies ............................................................................ (Abs. 102-107) Proffered papers 7: Evaluating and predicting toxicity in RT ........................................................................ (Abs. 108-113) Poster Highlights Poster highlights 3 CL : Prostate ...................................................................................................................... (Abs. 114-120) Poster highlights 4 PH: Intrafractional motion ............................................................................................... (Abs. 121-127)

Presidential Symposium Presidential symposium: Translating research and partnership into optimal health ................................ (Abs. 128-131) Symposium MR-guided Radiotherapy: state of the art and future perspectives ............................................................. (Abs. 132-134) Hypoxia-activated prodrugs: is there a future? .............................................................................................. (Abs. 135-138) Multimodal approaches in oligometastatic prostate disease: state-of-the-art ........................................... (Abs. 139-142) Debate This house believes that hippocampus avoiding whole brain irradiation is the current standard of care ........................................................................................................................ (Abs. 143-146) Symposium Surface guided radiation therapy .................................................................................................................... (Abs. 147-149) «Big data» approaches to quality improvement ............................................................................................ (Abs. 150-152) Radiotherapy: it´s all about the heart ............................................................................................................. (Abs. 153-155) Poster Highlights Poster highlights 5 CL : GI ................................................................................................................................. (Abs. 156-162) Poster highlights 6 RTT: Optimising techniques for breast and H&N RT ..................................................... (Abs. 163-169) Poster discussion CL: CNS ............................................................................................................................................................... (Abs. 170-175) CL: Breast 1 ........................................................................................................................................................ (Abs. 176-181) PH: Dose measurement and dose calculation ................................................................................................ (Abs. 182-187) PH: Treatment planning: applications 1 .......................................................................................................... (Abs. 189-193) Award Lecture E. van der Schueren Award Lecture .........................................................................................................................(Abs. 194) Jens Overgaard Legacy Award ..................................................................................................................................(Abs. 195) Proffered Papers Proffered papers 8: Cardiac toxicity ................................................................................................................ (Abs. 196-201) Proffered papers 9: Radiation effects on stem cells and the microenvironment ....................................... (Abs. 202-207) Proffered papers 10: Prostate .......................................................................................................................... (Abs. 208-213) Proffered Papers Proffered papers 11: Dose calculation for advanced techniques ................................................................. (Abs. 214-219) Proffered papers 12: Artificial Intelligence and automation ......................................................................... (Abs. 220-225) Proffered papers 13: Lung ................................................................................................................................ (Abs. 226-231) Poster Highlights Poster highlights 7 RB: Novel radiobiological targets .................................................................................... (Abs. 232-237) Poster highlights 8 PH: Planning and validation of ion beams ..................................................................... (Abs. 238-244) Teaching Lecture How can Artificial Intelligence improve contouring?. .............................................................................................(Abs. 245) How does radiotherapy change the tumour ecosystem........................................................................................(Abs. 246) Oligometastatic cancer scenarios: from biology to treatments. ...........................................................................(Abs. 247) Bladder conservation strategies...............................................................................................................................(Abs. 248) Radiosurgery: potential and pitfalls. ........................................................................................................................(Abs. 249) Dose calculation in external beam radiotherapy: The radiation transport equation and dose-to-water vs. dose-to-medium issues.......................................................................................................(Abs. 250) Patient empowerment in radiotherapy....................................................................................................................(Abs. 251) Joint Symposium ESTRO-ASTRO: Patient reported outcomes in radiation oncology - time to make them mandatory in clinical practice?................................................................................................................ (Abs. 252-255) Symposium Emerging links between radiation-induced anti-tumor immune effects and DNA damage repair signaling................................................................................................................................................... (Abs. 256-259)

SUNDAY 29 NOVEMBER 2020

Multimodal approach to oligometastatic breast disease: current state-of-the-art..................................... (Abs. 260-262) The role of radiotherapy in locally advanced pancreatic cancer................................................................... (Abs. 263-266) How to enhance the quality of treatment planning studies.......................................................................... (Abs. 267-269) Application of machine learning to CTV definition.......................................................................................... (Abs. 270-272) Patient involvement in radiation oncology...................................................................................................... (Abs. 273-275) Poster Highlights Poster highlights 9 CL: Lung.............................................................................................................................. (Abs. 276-282) Poster highlights 10 PH: Toxicity modelling..................................................................................................... (Abs. 283-289) Poster discussion CL: Breast 2......................................................................................................................................................... (Abs. 290-295) PH: Quantitative functional and biological imaging........................................................................................ (Abs. 296-300) PH: Treatment planning: applications 2........................................................................................................... (Abs. 301-306) PH: Adaptive radiotherapy and inter-fraction motion management 1......................................................... (Abs. 307-312) Proffered Papers Proffered papers 14: QoL and PROMs............................................................................................................. (Abs. 313-318) Proffered papers 15: Radiation response biomarkers................................................................................... (Abs. 319-324) Proffered papers 16: Breast.............................................................................................................................. (Abs. 325-330) Proffered papers 17: GI. .................................................................................................................................... (Abs. 331-336) Proffered papers 18: Intra-fractional motion management.......................................................................... (Abs. 337-342) Proffered papers 19: Auto-contouring using deep learning.......................................................................... (Abs. 343-348) Proffered papers 20: Ensuring precision and accuracy in RT........................................................................ (Abs. 349-354) Poster Highlights Poster highlights 11 CL : CNS............................................................................................................................ (Abs. 355-361) Poster highlights 12: PH Daily challenges in routine RT................................................................................. (Abs. 362-368) Plenary Session Clinical trials........................................................................................................................................................ (Abs. 369-374) Joint Symposium ESTRO-EORTC: Redefining oligometastatic disease: incorporating advanced imaging into clinical trials................................................................................................................................................. (Abs. 375-378) Symposium Use of 3-dimensional organoid models in radiation research...................................................................... (Abs. 379-381) Controversies in locally advanced breast cancer............................................................................................ (Abs. 382-385) Second malignancy after modern radiotherapy: more or less than historical precedents........................ (Abs. 386-389) Radiobiological guidance for treatment planning........................................................................................... (Abs. 390-392) Audits for advanced radiotherapy techniques................................................................................................ (Abs. 393-396) Meet the Expert Meet-the-Expert -RTT led MR............................................................................................................................ (Abs. 397-398) Poster Highlights Poster highlights 13 CL : Gynaecology. ............................................................................................................ (Abs. 399-405) Poster highlights 14 PH: MRI only planning..................................................................................................... (Abs. 406-412) Poster discussion CL: Lung............................................................................................................................................................... (Abs. 413-418) CL: Upper and Lower GI 1.................................................................................................................................. (Abs. 419-424) PH: Radiobiological and predictive modelling, and radiomics 1.................................................................... (Abs. 425-430) PH: Implementation of new techniques 1. ...................................................................................................... (Abs. 431-436) Plenary Session Highlights of Proffered papers.......................................................................................................................... (Abs. 437-439) Proffered Papers Proffered papers 21: Protons............................................................................................................................ (Abs. 440-445) Proffered papers 22: Radiobiological resistance mechanisms...................................................................... (Abs. 446-451) Proffered papers 23 : Palliation........................................................................................................................ (Abs. 452-457) Proffered papers 24 : Lymphoma..................................................................................................................... (Abs. 458-463) Proffered papers 25 - Clinical implementation of online MRgRT.................................................................. (Abs. 464-469) Proffered papers 26: New technology.............................................................................................................. (Abs. 470-475)

Poster Highlights Poster highlights 15: Particles and microbeams............................................................................................. (Abs. 476-481) Poster highlights 16 RTT: Novel strategies for treatment planning and delivery........................................ (Abs. 482-488)

MONDAY 30 NOVEMBER 2020

Teaching Lecture Cancer metabolism: a radio-oncology perspective.................................................................................................(Abs. 489) The treatment of anal cancer....................................................................................................................................(Abs. 490) Latest updates on non-metastatic nasopharyngeal carcinoma in 2020: screening, workup, and treatment paradigms........................................................................................................(Abs. 491) Validation and commissioning of AI contouring tools............................................................................................(Abs. 492) 4D imaging for radiation therapy using MRI and PET.............................................................................................(Abs. 493) Quantitative Digital Pathology Biomarkers of Neoadjuvant Therapy Response in Breast Cancer....................(Abs. 494) Novel Radiotherapy techniques/treatments (e.g. micro beam, FLASH, etc, possibly immunotherapy)............(Abs. 495) Joint Symposium ESTRO-EANM: Targeting the microenvironment in radiotherapy: where are we now?.............................. (Abs. 496-499) Symposium How to combine different treatment modalities in rectal cancer................................................................. (Abs. 500-503) Multidisciplinary treatment of salivary gland tumors..................................................................................... (Abs. 504-506) Target definition and dose prescription in the era of dose painting and probabilistic planning............... (Abs. 507-509) Joint Symposium ESTRO-EFOMP: Artificial intelligence and image quality (with focus on benefits for RT)............................ (Abs. 510-512) Symposium Individualised radiotherapy. ............................................................................................................................. (Abs. 513-515) Mobility grants report back............................................................................................................................... (Abs. 516-520) Poster Highlights Poster highlights 17 CL : Palliation. .................................................................................................................. (Abs. 521-526) Poster highlights 18 PH: MRI guidance. ........................................................................................................... (Abs. 527-533) Poster discussion CL: Upper and Lower GI 2.................................................................................................................................. (Abs. 534-539) PH: Radiobiological and predictive modelling, and radiomics 2.................................................................... (Abs. 540-545) PH: Implementation of new techniques 2. ...................................................................................................... (Abs. 546-551) PH: Adaptive radiotherapy and inter-fraction motion management 2......................................................... (Abs. 552-557) Proffered Papers Proffered papers 27: Novel technologies. ....................................................................................................... (Abs. 558-563) Proffered papers 28 : Gynaecology.................................................................................................................. (Abs. 564-569) Proffered papers 29 : Head and neck............................................................................................................... (Abs. 570-575) Proffered papers 30 - Protons and ions........................................................................................................... (Abs. 576-581) Proffered papers 31: Quantitative imaging and radiomics............................................................................ (Abs. 582-587) Proffered papers 32: Innovations in RTT practice and complex decision making....................................... (Abs. 588-593) Symposium Communication in professional life / how to communicate within the team......................................................(Abs. 594) Poster Highlights Poster highlights 19 CL : Breast........................................................................................................................ (Abs. 595-601) Poster highlights 20 PH: Auto-contouring using deep learning..................................................................... (Abs. 602-608) Plenary Session Highlights of Proffered papers (late-breaking abstracts)............................................................................... (Abs. 609-614) Symposium Young lunch symposium: Mentoring................................................................................................................ (Abs. 615-616) Preventing radiation-induced toxicity in head and neck cancer patients..................................................... (Abs. 617-620) Multidisciplinary treatment of hepatocellular cancer..................................................................................... (Abs. 621-624) Novel approaches in the management of non-melanoma skin cancer........................................................ (Abs. 625-628)

Debate This house believes that there is no future for adaptive radiotherapy in EBRT without an MR-linac....... (Abs. 629-632) Proffered Papers Proffered papers 33.2: Dosimetry and QA....................................................................................................... (Abs. 633-638) Symposium Challenging cancers........................................................................................................................................... (Abs. 639-641) How to become a department head. ............................................................................................................... (Abs. 642-646) Poster Highlights Poster highlights 21 PH: Predictive modelling................................................................................................. (Abs. 647-653) Poster discussion CL: Gynaecology. ................................................................................................................................................ (Abs. 654-659) CL: Head and neck 2........................................................................................................................................... (Abs. 660-665) CL: Prostate 2...................................................................................................................................................... (Abs. 666-671) RTT 2.................................................................................................................................................................... (Abs. 672-677) Award Lecture K. Breur Award Lecture..............................................................................................................................................(Abs. 678) Donal Hollywood Award............................................................................................................................................(Abs. 679) Proffered Papers Proffered papers 33.1: Image guided radiotherapy. ...................................................................................... (Abs. 680-685) Proffered papers 34: Particle therapy in CNS tumours.................................................................................. (Abs. 686-691) Proffered papers 35 : Late-breaking abstracts................................................................................................ (Abs. 692-696) Proffered papers 36 - Managing uncertainties in proton therapy................................................................ (Abs. 697-702) Proffered papers 37: 4D and Adaptive RT........................................................................................................ (Abs. 703-708) Proffered papers 38: Current status of MR guided RT................................................................................... (Abs. 709-714) Poster Highlights Poster highlights 22 PH: Outcome modelling.................................................................................................. (Abs. 715-721) Teaching Lecture Spatially fractionated GRID radiotherapy - rationale and promise.......................................................................(Abs. 722) Noninvasive cardiac radioablation for ventricular tachycardia.............................................................................(Abs. 723) Is it safe to treat central lung lesions with SBRT?....................................................................................................(Abs. 724) Sexual rehabilitation and management of sexual problems after treatment for pelvic cancer................ (Abs. 725-726) Dosimetry and QA for MR-Linacs..............................................................................................................................(Abs. 727) Overview of micro/nanodosimetry and application to particle beams................................................................(Abs. 728) Real time adpative radiotherapy with MRlinac........................................................................................................(Abs. 729) Symposium The latest news on FLASH: ultra-high dose rate radiotherapy...................................................................... (Abs. 730-732) Dose accumulation and re-irradiation for thoracic malignancies................................................................. (Abs. 733-736) Multimodal approaches to oligometastatic disease: state-of-the-art in NSCLC.......................................... (Abs. 737-740) Joint Debate ESTRO-ESGO: This house believes that lymph node dissection can be omitted in FIGO stage IB1/2(<4 cm)iN1(imaging) cervical cancer................................................................................ (Abs. 741-744) Symposium Quo-vadis log file based QA for adaptive radiotherapy?................................................................................ (Abs. 745-747) PBT planning: lessons learned.......................................................................................................................... (Abs. 748-750) Innovations in radiotherapy.............................................................................................................................. (Abs. 751-753) Ultra-hypofractionation for localised prostate cancer................................................................................... (Abs. 754-757) Joint Symposium ESTRO-IASLC: Combined radiotherapy and immunotherapy in NSCLC........................................................ (Abs. 758-761)

TUESDAY 1 DECEMBER 2020

Symposium Current status of radiotherapy for non-malignant disease outside the brain............................................. (Abs. 762-765) Joint Symposium ESTRO-ESR: Online MR-guided radiotherapy - Where are we right now?..................................................... (Abs. 766-769) Debate This house believes that radiomics will improve predictive models in RT................................................... (Abs. 770-773) Symposium Tumour tracking – is it worth the effort?......................................................................................................... (Abs. 774-777) Particle Therapy - possibilities and limitations................................................................................................ (Abs. 778-780) POSTERS Clinical track: Head and Neck............................................................................................................................ (Abs. 786-854) Clinical track: CNS............................................................................................................................................... (Abs. 855-909) Clinical track: Haematology............................................................................................................................... (Abs. 910-924) Clinical track: Breast........................................................................................................................................... (Abs. 925-986) Clinical track: Lung. .......................................................................................................................................... (Abs. 988-1033) Clinical track: Upper GI (oesophagus, stomach, pancreas, liver)............................................................... (Abs. 1034-1078) Clinical track: Lower GI (colon, rectum, anus).............................................................................................. (Abs. 1079-1115) Clinical track: Gynaecological (endometrium, cervix, vagina, vulva)......................................................... (Abs. 1116-1148) Clinical track: Prostate................................................................................................................................... (Abs. 1149-1204) Clinical track: Urology-non-prostate............................................................................................................. (Abs. 1205-1221) Clinical track: Skin cancer / malignant melanoma...................................................................................... (Abs. 1222-1228) Clinical track: Sarcoma................................................................................................................................... (Abs. 1229-1236) Clinical track: Paediatric tumours................................................................................................................. (Abs. 1237-1244) Clinical track: Palliation.................................................................................................................................. (Abs. 1245-1262) Clinical track: Elderly...................................................................................................................................... (Abs. 1263-1272) Clinical track: Health services research / health economics...................................................................... (Abs. 1273-1284) Clinical track: Communication. ..................................................................................................................... (Abs. 1285-1288) Clinical track: Other........................................................................................................................................ (Abs. 1289-1305) Physics track: Basic dosimetry and phantom and detector development............................................... (Abs. 1306-1335) Physics track: Dose measurement and dose calculation........................................................................... (Abs. 1336-1422) Physics track: Radiation protection, secondary tumour induction and low dose.................................... (Abs. 1423-1433) Physics track: Treatment plan optimisation: algorithms............................................................................ (Abs. 1434-1463) Physics track: Treatment planning: applications......................................................................................... (Abs. 1464-1522) Physics track: Radiobiological and predictive modelling, and radiomics.................................................. (Abs. 1523-1586) Physics track: Intra-fraction motion management...................................................................................... (Abs. 1587-1621) Physics track: Adaptive radiotherapy and inter-fraction motion management....................................... (Abs. 1622-1673) Physics track: Quantitative functional and biological imaging. ................................................................. (Abs. 1674-1696) Physics track :Imaging acquisition and processing..................................................................................... (Abs. 1697-1756) Physics track: Implementation of new technology, techniques, clinical protocols or trials (including QA & audit)...................................................................................................................... (Abs. 1757-1801) Radiobiology track: Radiobiology of normal tissues................................................................................... (Abs. 1802-1807) Radiobiology track: Radiobiology of stem cells (canser and normal tissue). .....................................................(Abs. 1808) Radiobiology track: Radiobiology of particles and heavy ions.............................................................................(Abs. 1809) Radiobiology track: Tumour microenvironment...................................................................................................(Abs. 1810) Radiobiology track: Immuno-radiobiology................................................................................................... (Abs. 1811-1821) Radiobiology track: Radiation and tumour metabolism.......................................................................................(Abs. 1822) Radiobiology track: DNA damage response................................................................................................ (Abs. 1823-1826) Radiobiology track: Biological therapies (e.g. viruses, vaccines).........................................................................(Abs. 1827) RTT track: Patient preparation, positioning and immobilisation............................................................... (Abs. 1828-1844) RTT track: Imaging acquisition and registration, OAR and target definition............................................ (Abs. 1845-1851) RTT track: Treatment planning and dose calculation / QC and QA........................................................... (Abs. 1852-1882) RTT track: Image guided radiotherapy and verification protocols............................................................ (Abs. 1883-1910) RTT track: Motion management and adaptive strategies. ......................................................................... (Abs. 1911-1923) RTT track: Patient care, side effects and communication. ......................................................................... (Abs. 1924-1932) RTT track: Education and training/role development................................................................................. (Abs. 1933-1942) RTT track: Risk management/quality management.................................................................................... (Abs. 1943-1947)

SUPPLEMENT World Congress of Brachytherapy 2020 abstracts selected for oral presentation and presented at ESTRO 2020 -Online Congress Sunday 29 November Proffered Paper Session: Prostate outcome and dosimetry............................................................... (OC-1026 – OC-1031) Proffered Paper Session: Imaging and dosimetry................................................................................ (OC-1032 – OC-1037) Monday 30 November Proffered Paper Session: Optimisation, verification & prediction...................................................... (OC-1040 – OC-1045) Proffered Paper Session: Optimising outcome in cervix BT................................................................ (OC-1046 – OC-1051) Proffered Paper Session: Rectum, Skin & Breast................................................................................. (OC-1053 – OC-1055)

ABSTRACTS

ESTRO 2020 S1

Saturday 28 November 2020

SP-0003 How to crunch the numbers P. Blanchard 1 1 Institut Gustave Roussy, Radiation Oncology, Villejuif, France Abstract text Use of an adequate methodology and statistics are essential to provide accurate and non-biased results when performing research. The talk will focus on key points that will help researchers perform high quality research that, ultimately, could be considered for publication in ESTRO journals, such as Radiotherapy & Oncology or Clinical and Translational Radiation Oncology. This points are related to 1) the design of the study and all the methodological work that needs to be performed prior to conducting the research, 2) basic elements of data analysis and 3) appropriate presentation and discussion of results. SP-0004 How to present your results nicely L.P. Muren Aarhus University Hospital, Department of Oncology, Aarhus, Denmark SP-0005 Differential biological effects of photon and particle irradiation; experimental highlights and clinical impact M. Durante 1 1 GSI Helmholtz Centre for Heavy Ion Research, Biophysics Department, Darmstadt, Germany Abstract text Particle therapy is rapidly growing worldwide. The main benefit is related o the physics, i.e. to the Bragg peak that allows much more sparing of normal tissue tann X-rays. However, densely ionizing (high-LET) radiation has quantitative and qualitative radiobiological differences from X-rays, While the proton LET is still so low that the biological effects are expected to be similar to photons, the increased biological effectiveness is the main rationale for the use of heavier ions such as carbon. In the figure below these physical and biological properties are summarized. The question is however whether these properties translates into a clinical benefit. We will discuss the current evidence and provide indications about which patients can especially benefit from charged particles. Abstract not received Teaching Lecture: Differential biological effects of photon and particle irradiation: experimental highlights and clinical impact

Teaching Lecture: The ultimate truth on how to get your paper published in an ESTRO journal

SP-0001 The world needs new knowledge M. Baumann 1 1 German Cancer Research Center DKFZ, CEO and Scientific Director, Heidelberg, Germany Abstract text Scientific journals drive innovation by reporting on new data and on novel developments in emerging fields. The integration of new knowledge from basic research to clinical outcome studies will lead to new treatments, improve the life-quality and life-expectancy of cancer patients, and will ultimately serve society. There is need for Radiation Oncology journals to publish hypothesis- driven prospective studies as well as retrospective studies, which provide new insights based on case-control data with sound statistical analysis and interpretation. Guidelines and reviews in form of state-of-the-art reports on newest treatments and research trends will further continue to serve as continuous education for both professionals and trainers. ESTRO’s four journals Radiotherapy & Oncology (The Green Journal), Clinical & Translational Radiation Oncology (ctRO), Physics and Imaging in Radiation Oncology (phiRO) and Technical Innovations & Patient Support in Radiation Oncology (tipsRO) are dedicated to disseminating high quality scientific knowledge to interdisciplinary professionals within the field. In this lecture participants will learn about the scope and the profile of the journals and how to choose the right articles for submission to the right journals, from the perspective of the editor in chief of the Green Journal. SP-0002 The ultimate truth on how to get your paper published in an ESTRO journal-ethical considerations. M. Leech 1 1 TCD Discipline Of Radiation Therapy, Radiation Therapy, Dublin, Ireland Abstract text When submitting to any of the ESTRO family of journals, authors should be fully aware of how to publish ethically. This presentation will outline the main considerations that authors should be cognisant of in relation to ethics. These include authorship and the ethical issues with gift, guest or ghost authorship, the ethical concerns regarding plagiarism, including using words and phrases right through to more serious plagiarism of the data and concepts of others. The concerns surrounding simultaneous submission, that is submitting duplicate works to more than one journal and so-called ‘salami slicing’, which is the dissection of data for one meaningful paper into several lesser papers will be highlighted. Research fraud includes the manipulation of data and is a serious offence. This, together with declaration of competing interests in research publications will be discussed. Finally, guidance on how to ensure that your work adheres to these ethical standards of ESTRO journals will be provided.

S2 ESTRO 2020

treatment planning. Apart from large reductions in treatment planning workload, also significant increases in plan quality have been reported, depending on the applied algorithm and performed study. Clinical implementation of these algorithms is not trivial. Apart from technical/algorithmic issues, also logistical and organizational aspects need to be carefully addressed for making clinical use a success. This lecture will focus on measures and conditions for effective, efficient and safe clinical use of automated planning.

Teaching Lecture: Fractionation in prostate cancer radiotherapy

SP-0006 Fractionation in prostate cancer radiotherapy N. Van As The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom

Abstract not received

Teaching Lecture: IAEA guide on Radiation Protection and Safety in Medical Uses of Ionising Radiation

Teaching Lecture: Which organs should be spared to achieve optimal dose distribution in thoracic tumours?

SP-0009 IAEA Safety Guide on Radiation Protection and Safety in Medical Uses of Ionizing Radiation P. Johnston 1 1 IAEA - International Atomic Energy Agency, Division of Radiation- Transport and Waste Safety- Department of Nuclear Safety and Security, Wien, Austria

SP-0007 Which organs should be spared to achieve optimal dose distribution in thoracic tumours? C. Muijs 1 1 University Medical Center Groningen- University of Groningen, Radiation Oncology, Groningen, The Netherlands Abstract text Radiotherapy might improve the outcome of thoracic tumors. However, this gain is at the expense of radiation induced complication risks, by co-irradiation of several normal tissues, such as heart and lungs. Recent improvements in photon techniques, like IMRT/VMAT and the use of breath hold, resulted in reductions of high dose regions in heart or lungs, which seems to decrease the risk of non-cancer related deaths. Proton beam radiotherapy reduces the dose to both heart and lungs substantially, especially low dose areas. The introduction of these new radiotherapy techniques, enabling accurate dose modification, raises the question how to prioritize these organs at risk. Historically, radiation oncologists focused on reducing lung dose to reduce the risk of radiation pneumonitis. However, recently also a wide spectrum of cardiac complications (coronary events, heart failure, arrhythmia) and even cardiac death were observed 1 . Both cardiac and pulmonary radiation induced complication are related to overall survival 2 . Moreover, the question of how to prioritize and/or reduce the combined risk of these toxicities is complicated by the interaction between heart and lungs. In summary, in the treatment of thoracic tumours both pulmonary as well as cardiac complication risks should be minimized. Proton radiotherapy reduces the radiation dose to both organs at risk. References Lin SH, Zhang N, Godby J et al. Radiation modality use and cardiopulmonary mortality risk in elderly patients with esophageal cancer. Cancer. 2016 Mar 15;122(6):917-28 Xu C, Guo L, Liao Z et al. Heart and lung doses are independent predictors of overall survival in esophageal cancer after chemoradiotherapy.Clin Transl Radiat Oncol. 2019 Apr 24;17:17-23.

Abstract text

Teaching Lecture: Do’s and don’ts in automated treatment planning – optimising conditions and expectations

Teaching Lecture: The evolution of RTT leadership in radiation oncology

SP-0010 The evolution of RTT leadership in radiation oncology M. Coffey 1 1 Trinity Centre for Health Sciences, Discipline of Radiation Therapy- School of Medicine, Dublin, Ireland Abstract text Firstly we need to consider what is a leader, how a leader evolves, the relationship between a leader and leadership and what we want from a leader of RTTs in the current and

SP-0008 Do’s and don’ts in automated treatment planning – optimising conditions and expectations B. Heijmen 1 , A. Sharfo 1 , L. Rossi 1 , J. Penninkhof 1 , M. Dirkx 1 , S. Breedveld 1 1 Erasmus Mc Cancer Institute Rotterdam, Radiation Oncology, Rotterdam, The Netherlands Abstract text Recently, many publications have appeared on development and validation of algorithms for automated

S3 ESTRO 2020

Abstract text Superficial skin cancer can be treated with a number of external beam modalities. The optimal technique is guided by depth of the target volume and proximity to organs at risk (OAR). The patient population is often elderly, and the ability to travel to the cancer center for repeat visits, as well as compliance with treatment setup and delivery must be taken into consideration when deciding on the dose fractionation regime and treatment modality. In this presentation, different methods for the treatment of superficial skin cancer with external beam radiation will be reviewed. Advantages and limitations of these methods will be discussed, along with comparison to brachytherapy techniques. Kilovoltage X-rays, including superficial and orthovoltage therapy, have the advantage of simple beam collimation, narrow penumbra, and relative ease of treatment setup; disadvantage includes the relatively slow dose drop off with higher energies and the high absorption of bone (f-factor) with lower energies. When using electron therapy the physical properties of the beam needs to be properly understood when prescribing treatment; bolus is required to ensure full surface dose, and an adequate margin around the target is needed to account for the wide penumbra, and as lower isodoses lines bow out at depth. The nuances of shielding are often more complicated with electron than with kilovoltage X- rays. Megavoltage photons are required for targets at depth, and IMRT or VMAT can be used to tailor the dose to cover large complex target volumes while minimizing dose to nearby OAR. IMRT and VMAT are useful techniques when treating large superficial targets over cured surfaces, such as the scalp. With stereotactic radiation, dose escalation to target is possible as using narrow margins, and may provide higher rates of tumor control and symptom palliation. However, rigid immobilization and longer treatment times are required and may not be well tolerated by all patients. Target delineation can be guided by incorporating ultrasound and MRI into the treatment planning process. Clinical cases will be used as examples, and recommendations given to help guide clinical practice. SP-0013 Which brachytherapy technique is optimal to manage complex skin targets? J. Guinot 1 , V. Gonzalez-Perez 2 1 Fundación Instituto Valenciano De Oncologia, Department Of Radiation Oncology, Valencia, Spain ; 2 fundación Instituto Valenciano De Oncologia, Department Of Radiation Physics, Valencia, Spain Abstract text Complex skin targets are related to extensive lesions as skull carcinomas with large targets, proximity of organs at risk as eye, anatomic uneven surfaces or cavities, and exophytic lesions. In all these situations, to achieve a good dosimetry is a challenge. New planning systems and high accuracy CLINACs allow for better isodose distributions, but air cavities and irregular shapes are difficult to be well covered. Dose on the skin is also a handicap, and bolus material not always adapts to the skin surface, Brachytherapy (BT) is being used for skin malignancies with excellent results. Most of the indications are related to small, not deep tumors or postoperative radiation to treat a few mm under the skin. These cases are well managed with contact brachytherapy, flaps, molds, or shielded devices. Complex skin targets need a different approach. Extensive superficial skull targets have dosimetric advantages when treated with personalized flaps or molds for contact brachytherapy. Dose is more homogeneous and brain receives lower doses. The proximity of organs at risk like eyes give advantage to interstitial BT due to the rapid fall-off of dose outside the target. Cavities like ear, orbit, nostrils, if included in the target offer the chance of making personalized molds to adapt the isodose to these irregular surfaces. And exophytic tumors need to be

future environment. The business dictionary defines a leader as a person or thing that holds a dominant or superior position within its field, and is able to exercise a high degree of control or influence over others (http://www.businessdictionary.com/definition/leader.h tml). The Collins dictionary defines a leader of a group of people or an organization is the person who is in control of it or in charge of it. Based on this narrow bsiness approach there are many RTT leaders in radiation oncology but do they actually demonstrate leadership or are they managing a service which, of course, is also valid? In a profession that, in the majority of countries, has no defined career pathway how can leaders rather than managers evolve? To support the evolution of leaders who are not necessarily managers but can come from any level within the team we need to take a broader view of the factors underpinning leadership. For the RTT profession to grow in the coming decades we must consider a leader as someone with a vision, who wants to bring about improvement and who guides and supports others to also become leaders. Professor Sandra Turner proposed that leadership in radiation oncology enables optimal clinical services and patient care, supports research and education and encourages initiatives at local, national and global level. Whilst there are many individual examples of leadership evolution amongst RTT community globally they are often in an individual silo with a predominantly local impact. The evolution of leadership from a pure management approach to one of vision and forward thinking impacting the totality of the profession is clearly demonstrated amongst the members of the ESTRO RTT community. Encompassing all elements of RTT practice and education members of this community are excellent examples of the evolution of leadership over three decades. Bringing their unique knowledge and skills they have supported the global growth of the profession from both a clinical and academic perspective. Dissemination of science through conferences, short courses, workshop and publications has grown exponentially over this period enabling colleagues to improve their own practice and thereby the care offered to patients. Coupled with the Train the Trainers project RTTs have been empowered to become directly involved in influencing the education standards within their local or national environment. The extensive network established has provided a platform for discussion and the evolution of shared vision for the future of the RTT profession and is a clear example of the evolution of leadership within our community. SP-0011 Simulation, applicator selection, planning and verification of complex skin targets. D. O'Farrell 1 1 Dana Farber/Brigham and Womens Cancer Center, Department of Radiation Oncology- Harvard Medical School, Boston, USA Abstract text Abstract: Surface brachytherapy necessitates some knowledge of specialized techniques and technologies to achieve safe and reproduceable treatment delivery. Here we show how our institution selects and treats patients with complex superficial targets and provide experience- based strategies for planning, optimization and verification. SP-0012 Which external beam modality is optimal? T. Barnes 1 1 Odette Cancer Centre, Radiation Oncology, Toronto, Canada Symposium: Management of complex skin targets-what is the optimal radiation technique?