S2785
RTT - RTT contouring, target definition, and treatment planning
ESTRO 2026
and high-dose sparing of OARs. Hybrid techniques, such as Hybrid-IMRT and Hybrid-VMAT, combine the strengths of both modalities, though data on these approaches remain limited. Conclusion: No single RT technique can be regarded as the definitive “gold standard” for left-sided early-stage breast cancer, as plan quality depends on multiple institutional and technical factors. Nonetheless, the OF method is largely outdated, aligning with the global trend toward more advanced planning strategies. Establishing an international framework for RT plan standardization would enhance inter-departmental comparisons and data consistency. Each department is encouraged to perform internal comparisons of available techniques and report outcomes using harmonized criteria to facilitate broader evidence synthesis. References: 1. Kaidar-Person, O, et al. (2022) Breast Cancer Radiation Therapy: A Practical Guide for Technical Applications. https://doi.org/10.1007/978-3-030-91170- 62. Halperin E.C., et al. (2008) Perez and Brady’s Principles and Practice of Radiation Oncology3. Khan, F. M., et al. (2020) Khan's the physics of radiation therapy. Lippincott Williams & Wilkins. https://doi.org/10.4103/jmp.JMP_17_204. Moher, D. et al. (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. https://doi.org/10.1371/journal.pmed.1000097 Keywords: early breast cancer, dosimetry, systematic review Continuous Monitoring of AI-Assisted Organ-at- Risk Segmentation in Radiotherapy for breast cancer patients Marianne Bessermann Johansen, Emil Rønn, Lise Bech Jellesmark Thorsen, Tine Bisballe Nyeng, Peter Pagh Schultz, Maja Voie Sand, Janni Arthur Mortensen, Birgitte Vrou Offersen, Anne Ivalu Sander Holm Department of Oncology, Aarhus University Hospital, Aarhus, Denmark Purpose/Objective: The adoption of Artificial Intelligence (AI) for organ-at- risk (OAR) segmentation in radiation therapy (RT) has increased substantially over the last decade. AI-based segmentation improves workflow efficiency and reduces inter-observer variability but may introduce systematic biases that can affect clinical quality. Continuous evaluation of AI model performance in real-world settings is therefore essential to ensure Poster Discussion 2788
Digital Poster 2785 Is There a Gold-Standard Radiotherapy Technique for Early-Stage Left-Sided Breast Cancer? – A Systematic Review of Planning Dose Assessment Fernando M. Costa 1 , Ruben Sousa 2 , Maria Gabriela Pinto 1 , Pedro Meireles 1 , Armanda Monteiro 1 , Isabel
Faria 2 , Manuel M. Piñeiro 3 , Jose G. Couto 4 1 Radiation Oncology Department, São João
Universitary Hospital Center, Porto, Portugal. 2 Medical Imaging and Radiotherapy Department, School of Health, Polytechnic of Porto, Porto, Portugal. 3 Applied Physics Department, School of Engineering, University of Vigo, Vigo, Spain. 4 Radiography Department, Faculty of Health Sciences, University of Malta, Msida, Malta Purpose/Objective: Adjuvant radiotherapy (RT) plays a pivotal role in achieving local control and prolonging overall survival in women with early-stage breast cancer. However, for left-sided tumours, cardiac and pulmonary dose exposure complicates treatment planning.1,2,3 This systematic review aimed to evaluate and compare photon-based RT planning techniques for early-stage left-sided breast cancer, focusing on target volume coverage and organs-at-risk (OAR) dose–volume parameters, and to determine whether a “gold- standard” planning method can be identified. Material/Methods: Following the PRISMA 2020 guidelines, a comprehensive search was conducted through PubMed, ScienceDirect, Cochrane Library, and PROSPERO databases for studies published between 2012 and July 2025.4 Inclusion criteria comprised studies: (1) that used linear-accelerator photon techniques, (2) compared at least two techniques, (3) treated the whole left breast only, and (4) reported planned doses for target volumes and OARs. Excluded were non-English studies, those treating right-side or bilateral breasts only, those with single planning technique or non-clinical TPS. The methodological quality of each study was evaluated using the Joanna Briggs Institute (JBI) critical appraisal tool prior to synthesis and interpretation of results. Results: Thirteen eligible studies were included. Techniques were categorised into: Open Fields (OF), Field-in-Field (FiF), Intensity-Modulated Radiotherapy (IMRT), Volumetric Modulated Arc Therapy (VMAT), Hybrid- IMRT, and Hybrid-VMAT. Across the studies analysed, the OF technique did not demonstrate superior outcomes for the PTV, lung, or heart. The FiF approach showed favourable results in reducing low and mean doses to OARs. IMRT provided improved Homogeneity Index (HI) values, while VMAT yielded higher Conformity Index (CI) scores and advantages in mean
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