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ESTRO conference

Last updated on 07 October 2011 

Clinical pre-meeting course
Wednesday, 9 May 2012

How imaging innovations can optimise multidisciplinary tumour boards’ choices
Jointly organised with ESOR

Course director: P. Lambin (NL) and A. Palkó (HU)

Course aims:
This course, jointly organized by ESTRO and ESOR (European School of Radiology), aims at promoting an integrated approach between specialists involved in multidisciplinary tumour boards to tailor the best treatment for each individual patient by exploiting the use of imaging.
New advanced imaging technology not only provides morphological information on tumour extension, but also information on tumour function and biology. It not only allows a good evaluation of tumour response during and after treatment, but also an early detection of tumour recurrence. Radiation oncologists increasingly use hybrid equipment in which diagnostic imaging technology is incorporated within the radiation treatment machines to allow continuous adaptation of radiation treatment according to the daily response of the tumour, the surrounding organs and their movement.
Thus there is a growing interest to enhance the collaboration between imaging specialists to optimise and to adapt the different uses of imaging to the comprehensive clinical management of the oncological patient.
By the combination of lectures and case discussions, this course aims to offer a programme focusing on the use of imaging in a truly multidisciplinary environment to support understanding between different specialists’ needs, practising common language and delineating research perspectives.

Who should attend?
The target group consists of radiation oncologists and senior residents and junior radiologists who are interested in learning and improving their knowledge on an optimal approach to multidisciplinary treatment management exploiting the use of imaging.


08:30 - 08:45

Opening remarks
Part 1 : Innovation in hardware
08:45 - 09:15 PET- MR : What are the prospective? - E. Rummeny (DE)
09:15 - 09:45 Dual energy CT : Preclinical and clinical experience - C. Zech (DE)
  Part 2 : Quantification of imaging
09:45 - 10:15 Standardisation in PET - A. Chiti (IT)
10:15 - 10:30 Coffee break
10:30 - 11:00 Diffusion MR: Potential and challenges - V. Goh (GB)
11:00 - 11:30 Quantification of response: beyond RECIST - L. Marti-Bonmati (ES)
11:30 - 12:00 Radiomics: how to get more out of imaging - P. Lambin (NL)
12:00 - 12:30 Discussion: Moderated by A. Palkó (HU)
12:30 – 13:30 Lunch
  Part 3 : Clinical session : What do we need to know in a multidisciplinary tumour board? State of the art and beyond
13:30 – 14:00 Head and Neck cancer - M. Becker (CH)
14:00 – 14:30 Lung cancer - L. Bonomo (IT)
14:30 – 15:00 Coffee Break
15:00 – 15:30 Prostate cancer - J.C. Vilanova (ES)
15:30 – 16:00 Rectum Cancer - R. Tan-Beets (NL)
16:00 – 16:30 Discussion and closing


Radiobiology pre-meeting course
Wednesday, 9 May 2012

Combining radiation with targeted therapies: concepts, opportunities and pitfalls

Course directors: C. Vens (NL) and A. Chalmers (GB)

Course aims:
Research into the mechanisms underlying resistance of tumours to radiation therapy has identified a number of key pathways that could be targeted in order to improve tumour control. And advances in drug development have provided us with new drugs to manipulate these pathways. But only a few of these targeted agents have been successfully combined with radiation therapy in the clinic, and the results have been mixed. The aim of this course is to provide an overview of the key concepts and pathways involved, and to discuss progress made and problems encountered in bringing radiation/targeted therapy combinations to the clinic.

Who should attend the course?
The course is targeted at radiation oncologists who may be aware of the existence of targeted therapies, and may even have prescribed them, but would like to learn more. In particular we will try to explain why and how these agents can be combined with radiation therapy. Research or scientific experience is not required, but the course will also be of interest to scientists undertaking radiation related research.


09:00-09:15 Welcome and introduction - C. Vens (NL) and A. Chalmers (GB)
09:15-09:30 Molecular targeted agents in combination with radiotherapy – a pharmaceutical industry perspective - O. Ataman (GB)
  PART I. Concepts and strategies
09:30-10:00 Targeting the DNA damage response - A. Begg (NL)
10:00-10:30 Targeting radiation induced signal transduction pathways - G. Higgins (GB)
10:30-11:00 Coffee break
11:00-11:30 Targeting the microenviroment to enhance tumour radiation responses - N. Cordes (DE)
11:30-12:00 Combining radiation with agents that target angiogenesis and vasculogenesis - E. Hammond (UK)
  PART II. Promises and Limitations
12:00-12:30 What to target and who to include? - K. Harrington (GB)
12:30-13:00 Lunch
13:30-14:00 Targeted therapy biomarkers for patient individualization - M. O’Connor (GB)
14:00-14:30 Biomarkers of radiation response - D. Zips (DE)
  PART III. Towards the Clinic
14:30-15:00 The radiation oncologist’s perspective: hopes and fears - R. Simcock (GB)
15:00-15:30 Coffee Break
15:30-16:00 Exploiting opportunities: how to design RT combination trials? - A. Chalmers (GB)
  PART IV. The future
16:00-16:45 Combining targeted radiation with targeted agents – a vision for the future….. - T. Lawrence (USA)
16:45-17:00 Final Discussion and concluding remarks - Anthony Chalmers(GB)  and C. Vens (NL)


Physics pre-meeting course
Wednesday, 9 May 2012
09:00 – 17:00 

What a physicist should consider before going into a proton therapy

Course director:  H. Nyström (SE)

Course aims:
In many countries in Europe as well as in the rest of the world, proton therapy facilities are either in the process of being created or are already well-established. In fact, the increase in the number of new facilities has been more or less exponential for many years, leading to an increased demand for medical physicists capable of carrying out proton therapy projects.
There are many obvious advantages when using proton therapy compared to conventional photon based radiotherapy, since a significantly larger fraction of the absorbed dose is actually delivered to the target volumes and an overall superior dose distribution is achieved.
However, substantial differences exist in terms of technology, treatment planning, dosimetry, QA etc. What is a reasonable staffing level? What is a reasonable “business plan”? How should acceptance testing be performed? What are the demands for clinical commissioning? What are the demands for treatment planning? What are the demands for QA?
This course aims at answering a few of the above-mentioned questions and at giving an overview of the particular aspects of radiotherapy that are specific to proton therapy. In particular those involved in the start up phase of a proton therapy project or those that are considering entering into such a project would benefit from participation.

Who should attend?
The participant in the course is expected to be a medical physicist experienced in conventional radiotherapy but curious about proton therapy.

09:00 – 09:30 What is the rational for going into Proton therapy and who is planning to do so? - H. Nyström (SE)
09:30 – 10:00 Introduction to the physics of protons and basic dosimetry for PT - A. Mazal (FR)
10:00 – 10:30 How to write the specifications - M. Schwarz (IT)
10:30 – 11:00 Coffee break
11:00 – 11:30 Business plan and staffing - H. Nyström (SE)
11:30 – 12:00 Clinical commissioning of a passive scattering PT system - A. Mazal (FR)
12:00 – 12:30 Acceptance testing and clinical commissioning of a scanning beam PT system - J. McDonough (USA)
12:30 – 13:30 Lunch
13:30 – 14:00 Treatment planning for passively scattered Protons, including margin concepts - M. Engelsman (USA)
14:00 – 14:30 Treatment planning for actively scanned Protons, including margin concepts - A. Lomax (CH)
14:30 – 15:00 CT scanning and the handling of image artifacts (including needed CT-QA) - M. Schwarz (IT)
15:00 – 15:30 Coffee Break
15:30 – 16:00 How to obtain an efficient patient flow in a multi gantry PT facility? - J. McDonough (USA)
16:00 – 16:30 QA and plan verification in complex situations, including IMPT - A. Lomax (CH)
16:30 – 17:00 Round table discussion and summing up 


Physics pre-meeting course
Wednesday, 9 May 2012

Recent Advances in Brachytherapy Physics
Jointly organised by GEC-ESTRO BRAPHYQS Group and the ESTRO Physics Committee

Course directors: J. LM Venselaar (NL) and D. Baltas (DE)

Course aims:
• To demonstrate the most recent developments in brachytherapy physics: a discussion on recent and future societal reports and recommendations,
• To discuss the developments in source calibration, quality assurance, and new equipment,
• To discuss the steps towards modern 3D conformal image based brachytherapy,
• To discuss new and forthcoming advanced treatment planning: model based dose calculation algorithms and inverse planning and optimisation methodologies in intensity modulated brachytherapy,
• To discuss the similarities and differences between modern 3D conformal ERT and BRT and its consequences for the concepts of margins.

Who should attend?
The course is aimed primarily at medical physicists and medical physicists in training, and at technologists willing to update themselves on the latest developments in brachytherapy physics. A basic knowledge of brachytherapy physics is required.

09:00-09:15 Introduction: towards modern brachytherapy physics - J. Venselaar (NL)
09:15-09:45 Source calibration: current and future developments - T. Sander (GB)
09:45-10:30 Approaches for 3-D dose calculation in brachytherapy - L. Beaulieu (CA)
10:30-11:00 Coffee break
11:00-11:45 Inverse planning and optimization methodologies in intensity modulated brachytherapy - D. Baltas (DE)
11:45-12:30 Image guided brachytherapy: use of CT and MRI, US, and PET - FA Siebert (DE) and TP Hellebust (NO)
12:30-13:30 Lunch
13:30-14:00 Uncertainties associated with the physical aspects: calibration and dose calculation - L. DeWerd (USA)
14:00-14:30 Uncertainties associated with the clinical steps: imaging, reconstruction, delivery and implications of inter/intrafraction alterations - C. Kirisits (AT)
14:30-15:00 Similarities and differences in modern 3D conformal Radiotherapy: ERT versus BRT and its consequences for margin concepts - K. Tanderup (DK)
15:00-15:30 Coffee Break
15:30-16:15 Quality management and specific QA procedures for modern imaging-based brachytherapy - M. Rivard (USA)
 16:15-17:00 In-vivo dosimetry: detectors, techniques and possible clinical applications - J. Cygler (CA)


RTT pre-meeting course
Wednesday, 9 May 2012

The delineation of normal structures: practice and challenges

Course directors: D. Pasini (IT) and S. Rivera (FR)
Course tutors: G. Mantello (IT), D. Genovesi (IT), B. Speleers (NL) and M. Leech (IE)

Course aims:
Intensity Modulated Radiotherapy Techniques (Static or rotational IMRT-techniques) rather than uniform intensity techniques give the ability to conform dose distributions to a variety of complex tumour sites/volumes while sparing nearby critical normal tissue structures (OAR) as possible.
The QUANTEC reports have summarised the evidence from a wide range of studies relating to the dose tolerance of the main OARs. Several of the reports highlight the issue of the normal tissue delineation considering both anatomical and functional aspects.
In order to achieve a greater level of accuracy in the definition of OARs, there is an urgent need to improve the knowledge of the anatomical limits of some selected structures. It is therefore important to become familiar with contouring procedures on the different imaging modalities implemented in the treatment planning systems, without neglecting the organ dose-volume tolerance.
This course will specifically focus on the anatomical definition of normal structures within the head and neck, thorax and pelvic regions.
An introductory lecture will illustrate the meaning of OAR delineation within the frame of the QUANTEC report.
The following section will be organised in:
1) A first theoretical part for each site, where an expert will give an overview of the delineation of the selected organ/s at risk in accordance with the QUANTEC recommendations,
2) It will be followed by a practical session in which the participants will have the opportunity to apply their knowledge in practice with the support of the faculty. They will be asked to contour organs on FALCON, an E-learning software tool based on the EDUCASE platform of ESTRO which has already been used successfully during previous workshops on target volume delineation.

In preparation for the course and to ensure maximum benefit, the participants will be asked to use the FALCON platform at home to delineate selected organs at risk. The same exercise will be repeated during the course and, after the experts’ lectures, the comparison between the exercises will be discussed by the teachers using FALCON tools.
As an outcome of the course we would like the participants to review their clinical practice in the context of the new recommendations of normal structure delineation and QUANTEC guidelines.

Who should attend?
This course is designed for radiation technologists involved in planning and radiation oncologists in training.

08:15 – 08:30 Introduction - D. Pasini (IT) and S. Rivera (FR)
08:30 – 09:00 Delineation of organ at risk in the QUANTEC era - G. Gagliardi (SE)
09:00 – 09:45 Practice and challenges in H&N OAR delineation (pharynx) - A. Eisbruch (USA)
09:45 – 10:00 FALCON - D. Pasini (IT) and S. Kaylor (USA)
10:00 – 10:30 OAR delineation in H&N:  Hands on contouring
10:30 – 11:00 Coffee break
11:00 – 11:15 Verification and discussion
11:00 – 11:45 Practice and challenges in Thorax OAR delineation (heart – brachial plexus) - U. Nestle (DE)
11:45 – 12:30 OAR delineation in Thorax: Hands on contouring
12:30 – 13:30 Lunch
13:30 – 14:15 Verification and discussion
14:15 – 15:00 Practice and challenges in Pelvis OAR delineation (rectum – small bowel ) - I. Syndikus (GB)
15:00 – 15:30 Coffee Break
15:30 – 16:15 OAR delineation in Pelvis: Hands on contouring
16:15 – 16:45 Verification and discussion
16:45 – 17:00 Conclusions



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