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Building a Successful Adaptive Radiotherapy Program

O Green1*, R Kashani2*, Q Wu3*, D Low4*, (1) Washington University School of Medicine, St. Louis, MO, (2) University of Michigan, Ann Arbor, MI, (3) Duke University Medical Center, Durham, NC, (4) UCLA, Los Angeles, CA


(Monday, 7/30/2018) 7:30 AM - 9:30 AM

Room: Karl Dean Ballroom B1

Adaptive radiotherapy (ART) has been a theoretical concept for decades but has only had limited practical applications during that time. The main reasons for the lack of clinical use were technological limitations and lack of clinical evidence to support systematic use of ART. Past several years have seen introduction of clinical tools and processes which make ART practical and these have been accompanied with a growing clinical data to support wider use of treatment adaptation. Radiotherapy as a field is rapidly approaching an era where ART will become a common place and routinely practiced in online and off-line applications. While ART in principle follows the same steps (imaging, contouring, planning, review, QA) as conventional RT, the implementation of these steps is generally significantly different. Practical implementation of ART, therefore, necessitates departure from conventional approaches and adoption of modified clinical practices. For foreseeable future, the clinical practices will involve simultaneous practice of conventional RT workflows and ART. Successful implementation of routine online and offline ART requires development of imaging, contouring, planning, QA, documentation, and other procedure. These procedures need to consider ART itself as well as integration with conventional RT processes. In most settings, implementation of ART will require fundamental revisiting of roles and duties for physicians, treatment planners, radiation therapists, and medical physicists. Considerations are also needed for the use of software and hardware for ART. While in most situations the software and hardware tools will be the same as for conventional RT, the clinical use of these tools for ART will be substantially different. ART also poses unique challenges for patient safety and QA. This presentation is designed to provide a deeper understanding of concepts for practical implementation of ART and to inform audience of clinical practices which have led to successful clinical ART programs.

Learning Objectives:
1. Provide an overview of current clinical evidence for adaptive radiotherapy
2. Review contouring strategies for adaptive radiotherapy
3. Provide considerations for treatment planning in adaptive radiotherapy
4. Review QA needs and concepts for adaptive radiotherapy



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