Session Item

Adaptive radiotherapy is increasingly being applied in the clinic in response to changes in patient anatomy. This will improve the precision of treatment and clinical outcomes. Traditionally limited by the availability of adaptive tools that facilitate clinical workflows, the widespread growth in automation of segmentation, planning, QA and treatment delivery is poised to make adaptation more commonplace. Supported by efficient tools, practical adaptive workflows are shifting roles and responsibilities within the multi-disciplinary team. RTTs for example have implemented models of care within standard practice requiring increasing dosimetric appraisal for plan-of-the-day approaches, or contouring and optimization skills for online plan adaptation. Even as automation of these tasks offers gains in efficiency, online clinical decision making and oversight is being shifted within the multi-disciplinary team. For RTTs trained or ‘credentialed’ in adaptive workflows this presently often takes the form of delegation of daily plan approval with ad hoc team support available remotely. Proficiency with adaptive radiotherapy will greatly increase in the coming years as a result of clinical experience and automated tools. The clinical team will be poised to introduce more aggressive adaptive strategies and there are opportunities in this space to allow provide advanced practice RTT models with increasing autonomy. Finally, automation will not only streamline technical adaptive workflows but may also disrupt the current provision of supportive care which will require a high level of engagement from the multi-disciplinary team and patients.