Adaptive Radiotherapy

COURSE Directors
J-J Sonke, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam (NL) and C. Fiorino, Scientific Institute San Raffaele, Milan (IT)

Course aim
Substantial geometrical uncertainties are associated with radiation therapy (RT), which limit its precision and accuracy and lead to possible overdosing of organs-and-risk (OAR) and/or underdosing the target. Recently, a variety of in room imaging systems have become available to visualize the position of the target and OAR just prior to treatment. These systems therefore enable image guided correction strategies, aligning the target with its planned position through a couch shift and thereby increasing the precision and accuracy of RT. More complex variabilities, such as differential motion between multiple targets, variations in posture and shape as well as treatment response, cannot be accounted for by using a couch shift and require more sophisticated correction strategies. Adaptive radiotherapy (ART), in which an active feedback loop is utilized to build an individualized patient model to modify the treatment plan, has the potential to account for these geometrical variabilities. Adaptive radiotherapy utilizes repetitive imaging to track temporal variations occurring between planning and delivery as well as over the course of RT. These changes are fed back to the treatment plan optimization process to minimize discrepancies between treatment intent and actual treatment delivery.

The goal of this course is to give a review of the current efforts in adaptive radiotherapy. It will cover the adaptive radiotherapy framework and important tools such as imaging and image registration. It will also cover more practical aspects such as quality assurance, clinical implementation and protocols.

Educational Programme

08:45 – 09:00  Opening remarks
09:00 – 09:30  The Adaptive Radiotherapy Framework: geometric uncertainties, imaging, feedback: Mike Sharpe (CAN)
09:30 – 10:00  Clinical perspective of ART: Vincenzo Valentini (IT)
10:00 – 10:30  Treatment response assessment: Tumor shrinkage: Robert Jeraj (USA)
10:30 – 11:00  Predicting OAR deformation: potentials for ART: Sara Broggi (IT)
11:00 – 11:30  Coffee break
11:30 – 12:15  Deformable Registration, Dose Accumulation and Verification: Kristy Brock (CAN)
12:15 – 13:00  Probalistic planning and prediction: Uwe Oelfe (DE)
13:00 – 14:00  Lunch
14:00 – 14:30  Adapting Radiotherapy for real-time intrafraction motion management: Paul Keall (USA)14:30 – 15:00  ART for Rectum and Prostate: Jasper Nijkamp (NL)
15:00 – 15:30  ART for cervix: Mischa Hoogeman (NL)
15:30 – 16:00  Coffee Break
16:00 – 16:30  ART for Lung: Jan-Jakob Sonke (NL)
16:30 – 17:00  ART for H&N: Di Yan (USA)
17:00 – 17:15  Discussion and closing