S1042
Clinical – Sarcoma, skin cancer, malignant melanoma
ESTRO 2026
metastatic and locally advanced cSCC, including as neoadjuvant therapy in patients initially considered unresectable and not suitable for radiotherapy.These results have established using Cemiplimab as a major therapeutic option for advanced disease. Emerging data suggest that combining radiotherapy with immunotherapy may be feasible and clinically meaningful in selected patients with locally advanced disease especially that advances in modern radiotherapy have made truly non-irradiable tumors exceptional. In resectable and high-risk cSCC, neoadjuvant and adjuvant trials have highlighted the expanding role of cemiplimab in earlier disease stages. While neoadjuvant treatment may increase surgical feasibility and early disease control, adjuvant therapy after surgery and radiotherapy further reduces the risk of recurrence. Across these settings, radiotherapy remains a pivotal element of local management, providing durable control. In current practice, radiotherapy remains essential across all stages of disease from palliative to curative intent, with technological advances improving precision, tolerance, and functional outcomes. Ongoing research aims to define the best strategy to achieve better disease control and improved quality of life within multidisciplinary care. Conclusion: Cemiplimab has transformed the management of cutaneous squamous cell carcinoma, extending treatment possibilities beyond surgery and radiotherapy. Nevertheless, radiotherapy remains a fundamental component for durable local control. Integrating both modalities within multidisciplinary pathways remains essential to provide individualized, effective care without compromising quality of life. References: Migden MR et al., N Engl J Med 2018;379:341– 351; Rischin D et al., Lancet Oncol 2020;21:294– 305; Gross ND et al., N Engl J Med 2022;387:1557– 1568; Maubec E et al., N Engl J Med 2024;390:827– 837; NCCN Guidelines®: Squamous Cell Skin Cancer, Version 2.2025, https://www.nccn.org; Porceddu SV et al., Curr Opin Oncol 2023;35:126–133. Keywords: cemiplima-radiotherapy-local control Skin radiotherapy planning: 2D photography and tracing paper vs 3D Mixed Reality (MR) headset and stylus. Stephen L Morris 1 , Elsa-Marie Otoo 2 , yagmur Gerek 2 , Rashi Chavan 2 , Regina Gonzalezvaz 3 , Emma Jones 3 1 Clinical Oncology, Guys Hospital, London, United Kingdom. 2 BioEngineering, Kings college, London, United Kingdom. 3 Radiotherapy Physics, Guys Hospital, London, United Kingdom Digital Poster 3162
Purpose/Objective: Conventional skin radiotherapy (RT) planning typically relies on 2D photography and tracing paper to capture and mark the clinical target volumes for planning and treatment set up. Emerging technologies, such as MR Headsets such as the Meta Quest 3 with its depth systems and MR Stylus devices, offer new opportunities for capturing patient surface data and aligning treatment regions with greater precision. The first phase of this project aims to first directly compare conventional 2D methods with advanced 3D approaches, assessing workflow, registration accuracy, and potential clinical benefits. The second phase will assess the feasibility of integrating 3D surface data storage and alignment into standard RT workflows. Material/Methods: The first phase involves the collection of both human volunteer surface models and surface data using both conventional 2D photography/tracing paper and 3D scanning with MQ3 and MR Stylus, ensuring datasets are stored for analysis. Alignment will then be performed in radiotherapy planning systems using both methods, with accuracy assessed through registration error metrics and reproducibility testing. Workflow efficiency will be measured by comparing time and ease of use, while user experience will be evaluated through clinician and technologist feedback on clinical utility and training value. Results: The first phase of the study is in development stage. We have mapped the skin radiotherapy workflows and developed the 3D MR technique using the 3D MQ3 and MR stylus 3D surface capture, data storage and digital registration. We have designed usability and clinician feedback evaluations. We are currently generating comparative evidence on the 2D and 3D planning approaches accuracy and reproducibility. Initial results show the technique to be user friendly, easy to learn and reproducible.
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