S3048
Invited Speaker
ESTRO 2026
support of children and young people with cancer.
measurements [8], investigate new developments in our understanding of repair pathways [9], and interpret competing experimental observations in the literature [5]. Whilst we stop short of predicting cell death, this bottom-up approach minimises reliance on empirical fitting, instead making ab initio predictions based only on radiation physics. This framework enables exploration of beam parameters and their impact on biological effectiveness, supporting future biologically informed radiotherapy optimisation. References: [1] N. T. Henthorn et al. , Radiat. Res. 2017, doi: 10.1667/RR14755.1 [2] S. P. Ingram et al. , PLOS Comput. Biol. 2020, doi: 10.1371/journal.pcbi.1008476 [3] J. Schuemann et al. , Radiat. Res. 2019, doi: 10.1667/RR15209.1 [4] J. W. Warmenhoven et al. , DNA Repair (Amst). 2020, doi: 10.1016/j.dnarep.2019.102743 [5] S. P. Ingram et al. , Sci. Rep. 2019, doi: 10.1038/s41598-019-42901-8 [6] N. T. Henthorn et al. , RSC Adv. 2019 , doi: 10.1039/C8RA10168J [7] J. W. Warmenhoven et al. , Radiat. Res. 2022, doi: 10.1667/RADE-21-00147.1 [8] S. P. Ingram et al. , Commun. Biol. , Dec. 2022, doi: 10.1038/s42003-022-03585-5 [9] Y. Qi et al. , Cancers (Basel). , May 2021, doi: 10.3390/cancers13092202 5528 Digital innovation and evolving approaches for children with cancer Michala Short College of Health, Adelaide University, Adelaide, Australia Digital innovation is rapidly transforming radiation therapy for children and young people with cancer. This teaching lecture will explore how evolving technologies are reshaping paediatric radiation oncology across the cancer journey, from treatment planning to long-term survivorship. Current international perspectives and guidance informing best practice will be reviewed, followed by an overview of novel technological approaches to paediatric simulation and treatment. Practical examples of digital innovations embedded throughout care will be presented, demonstrating how these tools can support personalised treatment and improved experiences for patients and families. The role of digital solutions in survivorship care, including monitoring late effects and supporting long-term follow-up, will also be discussed. The lecture will also cover future directions in digital innovation in paediatric radiation therapy for best
5529 Dosimetry audit impact Kate L Francis, Rhonda L Brown
Australian Clinical Dosimetry Service, Australian Radiation Protection and Nuclear Safety Agency (ARPANSA), Yallambie, Australia Radiation therapy is essential for cancer treatment and quality-of-life improvement, yet the potential for patient harm remains significant due to complex workflows and rapidly evolving technology. The Australian Clinical Dosimetry Service (ACDS) provides independent, standardised dosimetric audits to support radiation therapy facilities in improving the accuracy and consistency of dose delivery. The ACDS conducts a multi-level audit program across Australia and New Zealand, assessing a broad suite of contemporary radiotherapy techniques and platforms. Audit modalities range from mailed OSLDs and reference dosimetry in water tanks to array measurements in slab phantoms, and comprehensive end-to-end tests in thoracic and cranial phantoms. These audits cover treatment complexity from simple 3DCRT to advanced SABR and SRS in heterogeneous phantoms and include specialised machine audits along with emerging techniques such as plan adaptation and motion-management. The ACDS governance includes the Clinical Advisory Group (CAG), which is an independent panel of clinical experts nominated by the radiation oncology, radiation therapy and medical physics professional colleges in Australia and New Zealand. The CAG functions to ensure clinical relevance during audit development and an assessment of clinical risk from poor audit outcomes. The ACDS ANZ Dataset provides an independent mechanism to identify trends and outliers in audit performance. Since 2011, more than 1,400 audits have been completed, with approximately 10% resulting in an Out-of-Tolerance (OT) outcome. Issues have been identified across all nodes of the radiotherapy pathway, with common errors arising from IGRT processes limited to a single event to planning or beam modelling issues observed across multi-centre networks. The data is the basis for more than 30 peer- reviewed publications contributing to international medical physics knowledge impacting clinical and audit practice. Regular participation in high-quality, independent dosimetry audits enhances the accuracy of radiation dose delivery, supports consistency in clinical practice, and strengthens confidence in evolving technologies
and algorithms. Review and remediation of suboptimal audit findings have directly led to
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