Working in the Grayzone of Oncology - Challenges, exhausted paradigms and opportunities

Abstract:
The seminar aims to initiate discussions about the value of past and future treatment strategies to address the main challenges in modern radiation oncology: i) to improve outcome for can-cers of unmet clinical need and ii) to manage the tremendous increase of cancer patients pre-dicted for the next decade.
It becomes more and more evident that current paradigms of clinical RT practice are dramati-cally oversimplify the complexity of RT in the context of cancer biology and radiation response of tissues. This framework is based on partially outdated assumptions and almost completely relies on the correlation of spatial dose maps with clinical outcomes. The seminar will discuss candidates of ‘obsolete’ assumptions, because they potentially may delay further progression of RT quality.
As novel treatment strategy, the seminar will discuss the development of real-time adaptive RT. It facilitates increasingly safe and real dose conformality to be delivered in 1-4 high dose daily fractions, ideally suited to address the problem of increasing cancer patient populations. Technical and radiobiological aspects of real-time adaptive RT and the impact on treatment efficiency will be presented and discussed.
Finally, the importance and complexity of pre-clinical research in RT will be highlighted in the context of ‘hypoxia’ in cancer therapy.