S2909
RTT- RTT operational practice and workflow innovations
ESTRO 2026
emphasis on hepatic and pulmonary dose-volume parameters. Material/Methods: A total of 100 computed tomography–based radiotherapy plans (50 DIBH, 50 FB) were retrospectively analyzed. Dose–volume histogram (DVH) metrics were extracted for the target, liver, lungs, and heart. Statistical analysis included the Shapiro–Wilk test for normality, the Mann–Whitney U test for group comparisons, and Spearman’s rank correlation to explore associations between mean liver dose and hepatic volume parameters. Results: Compared with FB, DIBH yielded a significant reduction in mean liver dose (median 252 cGy vs 354 cGy; p < 0.001) and in liver volumes receiving 10–30 Gy (p < 0.001 for all). Modest but significant improvements in target coverage were noted under DIBH (V95 = 88% vs 85%; p = 0.008). DIBH further reduced mean heart dose (98.6 vs 105.2 cGy; p = 0.003) and right-lung V16 (22.5% vs 27.7%; p = 0.007). Mean liver dose showed a strong correlation with liver V10–V30 Gy ( ρ = 0.73–0.82; p < 0.001) and a moderate correlation with irradiated liver volume ( ρ = 0.41; p < 0.001). Conclusion: The DIBH technique provides superior hepatic, pulmonary, and cardiac sparing compared with FB, without compromising target coverage. Mean liver dose demonstrates a robust correlation with partial- volume metrics and may serve as a practical surrogate endpoint in plan evaluation and quality assurance for right-sided breast radiotherapy. References: Bruzzaniti V, Abate A, Pinnaro P, et al. Dosimetric and clinical advantages of deep inspiration breath-hold (DIBH) during radiotherapy of breast cancer. J Exp Clin Cancer Res 2013;32:88.Offersen BV, Boersma LJ, Kirkove C, et al. ESTRO consensus guideline on target volume delineation for elective radiation therapy of early stage breast cancer. Radiother Oncol 2015;114:3- 10. Estimating the risks of breast cancer radiotherapy: evidence from modern radiation doses to the lungs and heart from previous randomised trials C Taylor and others Journal of Clinical Oncology, 2017. Vol 35, issue 15. pages 1641-1649 Keywords: DIBH, radiotherapy, 3DCRT
Conclusion: Automation of treatment plan checks shifts the RTT’s role from execution to interpretation. While technical training can be addressed via e-learning or SOPs, contextual training must be carefully timed and supported by workplace monitoring. Seamless integration of automation into existing workflows is essential for safe and effective use. Keywords: Automation, risk mitigation, treatment planning Digital Poster Highlight 1417 DIBH versus free breathing: assessing liver and right lung dose volume post-right breast irradiation Nagwan Ibrahim Anter 1 , Medhat Mohamed Ei Sebaie 1 , Sabreen Abdo Mohammed 1 , Zeinab Hassan El Taher 2 1 radiotherapy, National cancer institute, cairo, Egypt. 2 Radiotherapy, National cancer institute, Cairo, Egypt
Purpose/Objective: Respiratory motion during right-sided breast
irradiation can increase incidental dose to the liver and right lung, potentially elevating the risk of late toxicity. Deep Inspiration Breath-Hold (DIBH) has been established as a technique to reduce heart and lung doses in left-sided breast cancer, but its dosimetric impact on the liver in right-sided treatments remains less characterized. This study quantitatively compares DIBH and Free Breathing (FB) plans with particular
Digital Poster 1539 Radiation therapy under strain: a mixed-methods study of workforce challenges
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