S1453
Interdisciplinary - Other
ESTRO 2026
defines a biologically homogeneous, radiosensitive subgroup that may be suitable for treatment de- escalation, while low CT expression identifies high-risk patients with impaired DNA repair and p53 function who could benefit from intensification of therapy (Figure 1). References: 1. Zeng, P. Y. F. et al. Immune-based classification of HPV-associated oropharyngeal cancer with implications for biomarker-driven treatment de- intensification. EBioMedicine 86, 104373 (2022).2. Kimple, R. J. & Harari, P. M. The prognostic value of HPV in head and neck cancer patients undergoing postoperative chemoradiotherapy. Ann. Transl. Med. 3, S14 (2015).3. Wang, C. et al. Systematic identification of genes with a cancer-testis expression pattern in 19 cancer types. Nat. Commun. 7, 10499 (2016). Keywords: HPV, biomarker, molecular stratification Digital Poster Highlight 3783 Will upright radiotherapy become a new standard? Perspectives from the global radiotherapy community. Sophie Boisbouvier 1,2 , Michelle Leech 3,4 , Lennart Volz 5 , Ye Zhang 6 , Amanda Webster 7,8 , Rita Simoes 9,10 , Mirjam Mast 11 , Amandine Bertrand 12,13 , Vincent Grégoire 1 1 Radation oncology departement, Centre Léon Bérard, Lyon, France. 2 UMR INSERM 1052-CNRS 5286, Centre de recherche en cancérologie de Lyon, Lyon, France. 3 Applied Radiation Therapy Trinity, Discipline of Radiation Therapy, Trinity College Dublin, Dublin, Ireland. 4 Radation oncology departement, Trinity St. James’s Cancer Institute, Dublin, Ireland. 5 Biophysics, GSI Helmholtz Center for Heavy Ion Research GmbH, Darmstadt, Germany. 6 Center for Proton Therapy, Paul Scherrer Institute, Villigen PSI, Switzerland. 7 Radiotherapy and Proton Beam Therapy, University College of London, London, United Kingdom. 8 Medical Physics and Biomedical Engineering, University College of London, London, United Kingdom. 9 Academic Radiography, The Royal Marsden Hospital, London, United Kingdom. 10 National Radiotherapy Trials Quality Assurance (RTTQA) Team, The Royal Marsden Hospital, London, United Kingdom. 11 Radiation oncology department, Haaglanden Medical Center, The Hague, Netherlands. 12 Pediatric oncology unit, Centre Léon Bérard, Lyon, France. 13 Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France Purpose/Objective: Upright radiotherapy(upRT) may offer clinical benefits for selected patients depending on the tumour site and treatment needs1. The perspectives about the
potential of upRT from the radiotherapy(RT) professionals are needed to guide numerous ongoing research projects. This survey aimed to explore the acceptability and the perspectives of upRT from RT professionals. Material/Methods: The survey was developed with the ESTRO P&I focus group support2. The questionnaire was pre-tested and piloted3. Seven RT professionals assessed question clarity and relevance using a 4-point Likert scale. The content validity index (CVI) was calculated. Items with a CVI<0.78 were reviewed for improvement or removal. Next, 15 RT professionals piloted the questionnaire, providing feedback on clarity and completion time. The final version of the questionnaire comprised 7 mandatory questions, 59 items assessed using a 4-point Likert scale and an “I don’t know” option, and 10 optional questions organised into 4 sections: upRT in your centre, acceptability factors, whatt would benefit from upRT and demographics. The study received IRB approval (R202-000-009) and was disseminated. Descriptive statistics summarised responses. Fisher’s exact tests assessed the influence of demographic data on responses. Results: From September to November 2025, 195 responses were collected. The number of analysable responses for each section and demographic data of the respondents are given in Table 1. Twenty-seven respondents had access to upRT. Among those without access to upRT (n=168), 35 responders (21%) are familiar with upRT, 128 (78%) would be willing to use it, and 65 (40%) believe it will become a standard in the coming years (Figure1). Professional role and experience had no significant impact (p>0.05). The main perceived benefits were improved psychological (n=107, 76%) and physical (n=100, 72%) patient comfort. Regarding the obstacles of the implementation, 93 respondents (73%) reported the complexity of multimodality imaging. The additional staff training and the availability of upright imaging (n=111, 80%) were the key challenges reported about upRT once implemented. According to the respondents, patients requiring a thoracic treatment (n=77, 65%), elderly patients (n=76, 62%) and patients requiring proton/ion arc therapy (n= 59, 49%) would benefit the most from upRT.
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