17-19 October 2024, Florence, Italy
Course director:
Prof Paul Van Houtte, Radiation oncology department, Institute Jules Bordet, Belgium
Course Report
When Dr Van Houtte asked me to write a report before the last session of this course, I knew it would be difficult to capture the atmosphere that prevailed among us over the three days. Nevertheless, I will try. I am Dr Sergo Mkhitaryan, a radiation oncologist at the National Centre of Oncology in Yerevan, Armenia, and a lecturer in the Department of General Oncology at Yerevan State Medical University. Being a radiation oncologist in Armenia is challenging, as there are only a few of us, and we must treat all types of malignant tumours. Therefore, before meetings such as this, I gather all the questions and complex cases I have encountered in my clinical practice with the aim of discussing them.
This ESTRO course provided an in-depth update on the fundamentals of lung cancer diagnosis and treatment. Speakers addressed each stage of the disease, type of treatment, and critical aspect in detail, while allowing ample time for questions. At times, there were so many questions that Dr Van Houtte had to ‘force’ us to take breaks.
Day 1: Dr Westeel explained how to diagnose lung cancer accurately, with emphasis on crucial nuances that may not catch the attention of every clinician. Dr Van Houtte introduced the new TNM classification of lung cancer, unfamiliar to many oncologists. TNM means the tumour size, the number of nearby lymph nodes that contain cancer and whether or not there is metastasis. Dr Ceresoli discussed the role of induction and adjuvant chemotherapy in the treatment of early-stage lung cancer in detail.
Day 2: Dr Berghmans provided an update for radiation oncologists on chemotherapy, immunotherapy, and targeted therapy, referencing numerous clinical trials and highlighting modern, promising drugs that are currently in clinical testing. Dr Dinkel illustrated the effects of radiation and immunotherapy on the lungs with multiple CT images of post-radiation pneumonitis and discussed differential diagnostics for other lung diseases that present similar CT images. Dr Van Houtte spoke about brain metastases and new treatment concepts that use recent advancements in radiation oncology.
Day 3: Dr Kuzdzal discussed the role of surgery in lung cancer treatment at various stages and underscored the importance of collaboration with radiation oncologists before making surgical decisions. Dr Kuzdzal made a dramatic point when he stated that radiation oncology might replace surgery as the primary treatment for lung cancer in the future. Dr Ramella thoroughly explained combined chemoradiation therapy for lung cancer and showed the evidence of its benefits in terms of numerous clinical trials and survival charts. Dr Berghmans, Dr Ruffini and Dr Putora presented details of a treatment approach for oligometastatic lung cancer. They highlighted how modern advances in radiation oncology, immunotherapy, targeted therapy and surgery now allow the treatment of patients with this disease, not just palliative care as in the past.
Conclusion: The course was highly productive; it integrated theory with practice and each argument and rationale was backed up with clinical trial data. The lecturers answered all questions comprehensively, and the interactive format, through which the audience answered questions before the lecturer explained the correct response and provided comments, was especially effective. The knowledge I gained during this course has given me greater confidence in my daily work and helped me to address many challenges that I face regularly. I highly recommend that all radiation oncologists, especially those who are early in their careers, attend ESTRO courses whenever possible. These courses provide a great opportunity to gain invaluable knowledge and to meet incredible people.
Sergo Mkhitaryan
Radiation oncologist, National Centre of Oncology, Yerevan, Armenia
Lecturer at general oncology chair, Yerevan State Medical University
