20-24 October 2024 I Vilnius, Lithuania

Treatment planning takes more than half of my work time, and striving to reach better results with every patient we treat has been one of my main objectives ever since I started this job.

I am Valeria Trojani and I work as a medical physicist at AUSL – IRCCS Santa Maria Nuova in Reggio Emilia, Italy. Since my trainee years, I have always found treatment planning fascinating and challenging. It is an activity that made my role as a medical physicist relevant to the therapeutic pathway of our patients.

I decided to attend this course to widen my view of this particular activity that I perform every day and to broaden my knowledge of clinical practice in Europe, which I knew to be different from my reality. This was my first ESTRO course and it was surprising to witness how well it was organised and staged. It definitely exceeded my expectations!

The lecturers dealt with compelling topics for all the healthcare professionals involved in treatment planning; there were interactive polls to engage with the audience and encourage discussion.

I was able to experience and try different treatment planning systems from different vendors, which was one of my goals, and to understand the differences among the commercial software that is available for planning. However, it was also possible for the attendees to focus on a single vendor, due to the pre-course survey in which it was possible to express such preferences. The faculty explained the cases that were used in the treatment planning workshop in detail by tackling important clinical aspects and real-life dangers of toxicities and adverse effects of radiotherapy. This provided the basis for understanding the rationale behind the proposed clinical goals and made us able to evaluate the priorities during the treatment planning process. The proposed cases were also deeply related to the lectures we attended during the morning.

Every course day offered a treatment planning session in the afternoon and a presentation of the obtained solution on a voluntary basis the following day. For me, this system was appealing due to the chance to engage in discussions on how the other attendees had tackled the specific case. The treatment planning solutions presentations gave me insights into techniques I did not know, such as how the paradigms change significantly when dealing with proton plans rather than photon plans. It was also interesting to discuss the decisions the different planners took about optimisation strategies and choices, while also emphasising that it is compulsory to study the obtained dose-volume histograms along with the plan 3D-dose distribution. The faculty provided conflicting clinical goals, which gave each attendee the space to grasp the concept of compromises based on clinical outcomes and to consider how to optimise treatment plans correctly. This system highlighted that the whole radiotherapy process is a multidisciplinary team effort, with the shared goal of better treatments and outcomes for the patients. The treatment planning sessions also gave us opportunities to compare our answers and engage with different healthcare professional figures.

My views about treatment planning but also radiotherapy in general widened during the course and I am glad I got to know so many professionals from around the world, compare our different practices and gain a glimpse into all the relevant research projects that are being tackled by the European community. I would recommend this course both to professionals who are approaching treatment planning as beginners and also to more experienced users to grasp how this activity is carried out in other institutions.

Valeria Trojani

Medical physicist (radiotherapy and radiology)

AUSL – IRCCS Santa Maria Nuova, Reggio Emilia, Italy

valeria.trojani@ausl.re.it