17-21 March, 2024

Athens, Greece

Course Director:  Bradley Pieters, Radiation Oncologist, Amsterdam University Medical Centers, Amsterdam (NL)

 

Course report by Elizabeth Chuk, Clinical research fellow from Toronto, Canada

My name is Elizabeth Chuk. I am a clinical oncologist by training and currently a clinical research fellow in the Department of Radiation Oncology at the Princess Margaret Cancer Centre, Toronto, Canada. I am delighted to share my fruitful experience of the ESTRO course named Comprehensive and Practical Brachytherapy, which was held in the beautiful city of Athens.

Brachytherapy fascinates me as a radiation oncologist, given its high conformity to the tumour, which enables the delivery of a high radiation dose to the primary growth while minimising the dose to surrounding organs at risk. It requires a good combination of radiation planning, dexterity skills and dosimetric optimisation. Implementation of these requires excellent teamwork, logistics coordination, and effective communication between team players. The art and science of brachytherapy appeals to me, and this appeal motivated me to take part in this course.

It was an intensive five-day course in which multiple cancer sites were covered: gynaecological, prostate, breast, skin, head and neck, oesophageal, bronchial, ocular, paediatric, etc. It was taught through a good mixture of well-prepared didactic lectures, close-up videos, photographs of brachytherapy procedures in action and findings during follow-up regarding treatment response.

The faculty consisted of experts in the field. They were knowledgeable, clear in their teaching, and very patient in answering every question asked in a packed classroom. The opportunities to interact with and pick the brains of the experts regarding difficult scenarios were invaluable. I have learned about ways to circumvent challenging anatomies and to derive creative solutions when the applicators available to me are not the same as demonstrated. Brachytherapy applicator insertion and plan are not bound by the applicators or imaging technology used but can be crafted carefully with experience and a team of excellent radiation therapists, physicists and radiation oncologists.

Before the course, a cervical and prostate case had been sent out for contouring on the Educase system. Attendees could compare their pre- and post-course contours on the metric system, which provides unbiased feedback in comparison with the faculty’s contours. The contouring homework was a great opportunity to learn from a faculty member one-on-one.

There were also ample interactive sessions with physicists on dosimetry planning and demonstrations made by industry representatives from Elekta and Varian of the common applicators used. To resonate with recent advances in the field, there were engaging sessions such as one on 3D printing and another on comparison of brachytherapy with proton-therapy plans, which would be especially useful in the field of paediatrics radiation.

Besides the rigorous academic coursework, the social dinner was splendid and well-arranged. There were many chances during this event and the coffee breaks that were scattered throughout the course to chat with other participants, who comprised an international cohort of enthusiastic radiation oncologists, radiation therapists and physicists diverse in levels of experience. I met many like-minded friends, with whom I hope to keep in touch long after this course.

All in all, I could not recommend this course enough to anyone who aspires to contribute to the field of brachytherapy! It is well-designed, compact and interactive. I am sure it will benefit incoming learners as much as it did for me.

Elizabeth Chuk

Clinical research fellow

Department of Radiation Oncology

Princess Margaret Cancer Centre

University of Toronto

Email: Elizabeth.chuk@gmail.com, Elizabeth.Chuk@uhn.ca

 

Course report by Elena Barbara Celia, radiation oncologist from Aosta, Italy

My name is Elena Barbara Celia. I am a radiation oncologist resident at Umberto Parini Hospital in Aosta, Italy. I am delighted to share my experience of the latest Comprehensive and Practical Brachytherapy course, which was run by ESTRO in March.

It was a five-day intensive course with different teaching modalities (didactic lectures, homework, online sessions through the platform Moodle and practical sessions that involved applicators, contouring and treatment planning) performed by high-profile and dedicated radiation oncologists, physicists, radiation therapists and representatives of brachytherapy vendors (Elekta, Varian).

The aim of the course was for attendees to become familiar with the theory, indications and dosimetry of this complex form of treatment, in order to facilitate further practice, enhance future opportunities and to consider what the recent advances in technology have made possible. The course provided a complete and interactive journey through brachytherapy, from the basis and general principles to advanced concepts in the main clinical subjects (gynaecological, urological, breast, head and neck, bronchial, oesophageal, skin and paediatric cancers).

The teachers described and showed their current clinical practice with workflows, images and videos. They also set aside time in which to clarify how the current, most widely available tools were used to obtain optimal implants and accurate dose distribution.

The staff presented cases of standard and personalised treatments, and discussed how the high degree of personalisation that can be achieved in brachytherapy could be exploited in the treatment of cancers at various anatomical sites, some of them uncommon. Customised production of applicators, through manual moulding or 3D printing, was discussed.

Considerable multidisciplinary cooperation at every step of the procedure is required, and this was exemplified in the collaboration between the different team members during the course.

In the intervals between sessions, participants were able to elaborate and compare their levels of knowledge and experience in an international and friendly atmosphere. The presence of people from all over the world sparked interesting exchanges.

Faculty members were always present, and were ready and willing to meet the needs of the attendees, both in training and non-training activities; they constantly gave exhaustive answers to the numerous questions from the attentive audience and even performed “sirtaki” in a Greek restaurant! Special thanks should go to the teachers for the effort and passion they put into this demanding course and for sharing their knowledge. Their enthusiasm was contagious. Thanks also to the company representatives.

I found it stimulating and exciting to take part in this ESTRO course. As a brachytherapy beginner, it was exactly what I needed, and more experienced people thought the same! I recommend that all interested colleagues participate in this and other ESTRO courses in order to expand their knowledge of this important discipline.

 

Elena Barbara Celia

Radiation oncologist resident

Umberto Parini Hospital

Aosta, Italy

elena.b.celia@gmail.com

ecelia@ausl.vda.it