SP-0303: Against the motion
F. Moura · Radiotherapy and Oncology · 2013
With the increasing age of the European population, the number of cancer patients will increase further in the coming decades.Besides surgery and systemic therapy, radiation therapy is an important part of the primary (and palliative) treatment in many tumour sites.The radiation oncologist is spending more and more time on the multidisciplinary approach of the cancer patient.Furthermore, preparing modern radiotherapy is becoming more time consuming for the radiation oncologist.And, among others, organs at risk have to be delineated.Because, in doing so, the dose to the OAR can be kept low resulting in a lower probability of radiation induced side effects.Also, highly conformal techniques and hypofractionation schemes become the current practice and, a precise delineation of the OARS becomes even more important.Automatic delineation programs exist and can be helpful to perform a standardized OAR delineation to guide the RTT to an optimal delineation of OAR.Proper training is necessary to distinguish between normal tissue and tumour extension.The RTT is more and more involved in the treatment planning process and delineating the OARs overlap for several tumoursites.In the training of the RTTs the delineation on MRI on PET-CT should be included as well, it appeared that for some tumoursites the OARs can be visualised better on those imaging modalities.Finally, when the guidelines for delineation of the OARs are defined precisely, we can move over to another level in the delineation of structures.Radiation therapists might perform the delineation of the CTV of some tumour sites, to increase the departmental efficiency and to decrease the interobserver variability of delineating the CTVs.Batumulai et al. stated that the interobserver variability between radiation oncologists and radiation therapists was low, and their study provided support in CTVBreast delineation by the radiation therapists based on a standardized protocol [Batumulai et al, 2011].Conclusion: To avoid a delay in the treatment and to increase the level of uniformity, delineation of the OARs by properly trained radiation therapists is the next step in the process of preparing an optimal radiation treatment.