Organised by IPEM's Radiotherapy Special Interest Group
Following our recent call for papers for the Online Monitoring of Radiotherapy Treatment meeting we have received a number of high quality submissions, but have identified a gap in proffered topics, relating to adaptive approaches. We have re-opened submissions and encourage authors to submit their “Adaptive approaches to Radiotherapy Treatment”. Case reviews, clinically implemented adaptive approach paradigms and emerging/proof of concept submissions are encouraged. Submission deadline 1st March. The emerging MR-Linac platform may provide the ultimate panacea, though still to be clinically implemented in the UK, Dr. Michael Roach, will give a keynote address highlighting the practical implementation and patient benefits that can be realised. Only a mere 20 years ago, you could be forgiven for thinking radiotherapy patients did not move and their tumours did not change during treatment! We know this because radiotherapy treatments were set up to external fiducial markers and treatment delivered with no, or little, image verification. Treatment borders were large and required no further validation. However whilst treatments were effective, side effects were prevalent.
Wind the clock forward to 2018. The demands on the radiotherapy delivery system have increased significantly with the introduction of new techniques and technologies. Tumours are no longer considered square and static, margins are tighter and there is a real need for validation and verification of treatment in real time, on an individual patient basis. Online monitoring is therefore becoming a desirable feature to be fully incorporated in modern radiotherapy, as a means to avoid errors, verify treatment delivery and highlight changes in machine performance. It also plays a major role in adaptive treatment where imaging can inform not only positioning but also the need for re-planning.
Many contemporary technologies may be employed to monitor radiotherapy treatment in real, or near-real time to provide assurance. These include systems such as:
Despite recommendations made in 2010 (Towards Safer Radiotherapy) and 2012 (NRIG IGRT Guidance for Implementation and Use), to use real time monitoring systems to reduce and correct uncertainty resulting from patient physiological movements, online monitoring technology for Radiotherapy Treatment is yet to mature and be fully integrated in clinical pathways in radiotherapy departments.
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