S2977
Invited Speaker
ESTRO 2026
radiation addresses this challenge. Adaptive radiotherapy has been originally defined as
At the same time, radiation oncology is expanding beyond its traditional boundaries. As cancer treatment becomes increasingly multimodal, the quantitative frameworks developed for radiation therapy should be generalized to optimize the combination of therapies, including systemic agents and radiopharmaceuticals. Emerging approaches, such as biomarker-driven adaptation and optimal stopping strategies, illustrate how treatment decisions can evolve dynamically over time based on imaging, delta- biomarkers, and patient-reported outcomes (PROMs). Another implication of this trajectory is the need to expand access to advanced technologies. Innovations that reduce the cost and complexity of high-precision treatments - including more compact delivery systems - are essential to ensuring that the benefits of modern radiation therapy reach patients around the world. 5244 Van der Scheuren Award - Thinking like a mountain! Alina Emiliana Sturdza Radiation Oncology, Medical University of Vienna, Vienna, Austria A well-known “secret” of persistence and progress is a stable, broad base of knowledge and thoughtful planning for the future. Being connected to other disciplines, while remaining curious and dedicated to your field, can only lead to success. Draw inspiration from nature, history, and your predecessors; stand up for your ideas, and remain humble when success shines. Do you want to see the future? Follow the research and ask yourself: what will this lead to in 5, 10, or 50 years? Share your knowledge and wisdom, be considerate toward your peers—and then your mission is complete. 5245 Regaud Award - Adaptation in radiation oncology Daniel Zips Radiation Oncology, Charite, Berlin, Germany Adaptation describes a concept of reactive interventions in one or more components of radiotherapy accounting for individual variations before, during and after treatment. The lecture will focus on adaptation during the course of radiotherapy. The therapeutic ratio in radiation oncology remains a major challenge despite better understanding clinical radiobiology and advances in technology. Adaptation to variations in positioning, geometry, biological characteristics and response to
reoptimization of the initial plan based on a systematic feedback of positional and geometric variations during the course of radiotherapy. Five exemplary prototypes for adaptation during the course of radiotherapy will be discussed: (1) adaptation to geometric and positional variation for safe dose escalation, (2) adaptation to variation in tumour characteristics assessed by functional imaging for safe dose de-escalation, (3) adaptation to variations in radioresistant subvolumes within the tumour, (4) adaptation to variation in organ function for individualized dose guidance, (5) accounting for PROMs variation during the course of radiotherapy as systematic feedback for personalized adaptive radiotherapy. Further development of the concept supported by continuous advances in biomedicine, medical physics, computational power, imaging and radiation technology will make multimodal complex adaptation available for the majority of patients undergoing radiotherapy resulting in further optimized therapeutic ratio.
5247 Boron-neutron capture therapy
Mikko Tenhunen, Liisa Porra, Lauri Wendland, Tiina Seppälä, Venla Loimu, Tanja Mälkiä, Anu Anttonen Comprehensive Cancer Center, HUS, Helsinki, Finland There are many tumours for which local control cannot be achieved with current radiotherapy techniques. Boron neutron capture therapy (BNCT) provides a different approach to deliver radiation with precision that matches the cellular scale. In BNCT 10 B captures a neutron: 10 B(n, α ) 7 Li+ γ . The resulting 7 Li and α ( 4 He) release their energy within a range of the cell diameter. The cross section σ of 10 B to thermal neutrons exceeds those values of the common elements in tissue, like hydrogen, carbon and
oxygen by several orders of magnitude: σ ( 10 B) ≈ 10 4 σ ( 1 H), σ ( 10 B) ≈ 10 6 σ ( 12 C), and
σ ( 10 B) ≈ 2 · 10 7 σ ( 16 O). Even tens of µg/g concentrations of 10 B effectively modulate the dose distribution at the microscopic scale. The epithermal neutron beam is a good compromise between penetration in tissue, a low proportion of high energy neutrons, only increasing dose bath to all cells, and a high proportion of thermal neutrons that are most important for boron capture. The total dose consists of several high-LET components with different biological efficiencies, that are expressed through the
concept of weighted dose D w : D w = w B D B + w n D n + w p D p + w γ D γ
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