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Article type: Spotlight on...
Keywords: ESTRO, .
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Thirty years on, ESTRO remains focused on its vision for a cure
ESTRO was set up in 1981 to ensure that radiation oncology could play its full part alongside other disciplines in the developing field of cancer care.
» Marc Beishon
ESTRO was set up in 1981 to ensure that radiation oncology could play its full part alongside other disciplines in the developing field of cancer care. This May, thousands of members celebrated its achievements at an anniversary conference, and then turned their focus onto the many challenges ahead.
The European Society for Radiotherapy and Oncology (ESTRO) celebrated its 30th anniversary in London this year at a special conference that brought together its main regular events as well as introducing a new one, the ESTRO International Oncology Forum, which included 'the opportunity to review 30 years of radiation oncology in 30 hours.’
“You don’t usually have an anniversary clinical track at conferences – it was a unique chance to review the evidence-based medicine generated over the last 30 years and how it prepares us for the future,” says Jean Bourhis, ESTRO’s current president, and head of the radiation oncology department at the Institute Gustave Roussy in Paris.
Although the history of radiation oncology goes back much further, the society can certainly be proud of its achievements, which are chronicled in a book prepared for the occasion, ‘Three decades of ESTRO: a vision for cancer cure’. It details the desire of ESTRO’s founders, who had mostly trained in the US, to establish a more united front in Europe after they had witnessed divisions in specialties in America, and indeed there was an idea for a ‘European Society of Oncology’, integrating all disciplines. But the feeling prevailed that radiotherapy needed its own distinct voice, as medical oncologists began their rise, but they would also include allied disciplines such as radiobiology and medical physics.
There was the challenge too of distinguishing radiation oncology from the much larger community of radiology at a time when some saw radiotherapy as a dying specialty, as the era of chemotherapy started to take hold. After holding its second meeting at the European Association of Radiology’s conference in 1983, ESTRO went its own way in the following years.
Special mention is made of Emmanuel van der Schueren, widely recognised as a brilliant clinical scientist and the driving force behind ESTRO, first as executive secretary and then president, and also editor of the society’s journal, Radiotherapy and Oncology. A professor of radiotherapy at Leuven, Belgium, he died far too soon from cancer in 1998, but has left a lasting impact on European oncology.
Van der Schueren’s fellow ESTRO founders must be name-checked too, as they are also pivotal figures – Klaas Breur, Jerzy Einhorn, Michael Peckham and Maurice Tubiana – who together set in train an organisation that has built up a membership of close to 5000.
As befits a field that covers a wide territory, scientifically and clinically, there are now several regular meetings in addition to the main ESTRO conference, which is annual but takes place at ECCO every other year. There are biannual meetings for physics and for the GEC group (Groupe Européen de Curie-thérapie – a clinical trials meeting that merged with ESTRO in 1990).
More recently, ESTRO has started running PREVENT, on the side-effects of radiotherapy, and an event on novel targeted drugs and radiotherapy. And there is CERRO, an experimental radiation oncology meeting, as well new events on head and neck oncology and molecular imaging.
As Bourhis notes, meetings and the journal contribute to communication, one of three pillars that ESTRO is organising its work around. “We are growing our own meetings and also organising more with multidisciplinary partners,” he says, noting that working with other specialties is in his opinion still the most pressing issue at clinical level in Europe.
Pulling up standards
The second pillar, education, is particularly important because of the variations in quality in using increasingly complex equipment and regimens. Bourhis says ESTRO has been careful not to expand its courses too quickly so as not to compromise quality, but it now runs more than 30 courses both inside and outside Europe – twice as many as in 2005. Significant numbers of attendees come from eastern Europe, Africa and the Far East, he says, with about 40% from western Europe. It all adds up to some 3000 attendees and 200 teachers a year. ESTRO’s core curriculum has also recently been revised, and it has now been integrated into the national teaching programmes of countries such as the Netherlands and Spain.
E-learning is playing an increasing part in ESTRO’s education plans, adds Bourhis. The society has a platform called Eagle (ESTRO's application for global learning), for online tutored courses, which has so far been used for rectal cancer, with courses for breast and head and neck to come. Another offering, called Falcon, is a combined workshop/online platform for anatomic delineation and contouring, which aims to address one of the biggest and most unpredictable sources of error in radiation oncology. “At ESTRO 30 we also launched the ESTRO Fellow, a position that people can attain after gaining a certain number of credits and passing an exam,” says Bourhis.
The third pillar of ESTRO’s work is policy, which Bourhis says has probably been the most challenging for all cancer societies in Europe, but which has received a big boost now that ECCO is more effectively presenting a joint front.
ESTRO past-president Michael Baumann, whose contribution to the field of radiation oncology was profiled in Cancer World Jan–Feb 2006, is the current president of ECCO. He and other ESTRO leaders have been uncompromising in fighting ESTRO’s corner in European oncopolitics, but it has been tough to gain the level of representation they feel the society needs within ECCO, and also politically on the European stage.
The level of investment needed by healthcare systems in radiotherapy is much higher than most other medical treatments, and ESTRO is acting once again to raise awareness of the economic benefits of its specialty, recognising that awareness of radiotherapy remains poor among not only the public and politicians, but also healthcare purchasers. A new project called HERO (Health Economics in Radiation Oncology), run by a taskforce from Europe and Canada, has started to look at the need for radiotherapy, its provision and accessibility, waiting lists, staffing, cost accounting and economic evaluation.
Taskforce member Yolande Lievens, from Leuven, explains that the project is an extended update of a 2005 study that was funded by the European Union called QUARTS (Quantification of Radiotherapy Infrastructure and Staffing). The radiation oncology community has still “barely started” evaluating the economic aspects of its treatments, she says, while other disciplines such as medical oncology have been doing better for some time.
ESTRO is acting once again to raise awareness of the economic benefits of its specialty
Aims of the HERO project include the development of economic models to calculate the value for money of treatments, and using data for lobbying and policy making. Preliminary data from a questionnaire were presented at ESTRO 30, with final results expected in 2013.
A very wide agenda
ESTRO has one of the widest agendas of any cancer specialty, covering as it does, for example, core European curricula for clinicians, physicists and radiotherapy technicians. This, together with the various meetings and educational activities, makes it quite a challenge just to organise its own affairs, let alone tackle the wider multidisciplinary integration that Bourhis says is vital.
A long list of actions are in train to address issues such as increasing membership and attracting younger members – the society would like to increase its number to 8000 by 2015, which would still be only about half of its target ‘market’. Like other European oncology organisations, however, it faces the tricky problem of whether and how to extend terms to national radiation oncology societies. Representing more of the various sub-specialties at board level is another issue, as is forging ethical collaboration with industry – the society has recently expanded its corporate membership programme, and now offers a ‘gold level’ whereby companies can participate in an advisory corporate council for promoting research and education.
ESTRO has certainly made a concerted effort to increase its profile and professional presentation, with the 30th conference being a flagship, and has engaged top-level public relations support, produced the anniversary book, created the new fellowship and started additional activities. With a solid platform in conferences and education, the emphasis is now on pushing forward its standards and guidelines in the multidisciplinary context, which will need both consistent engagement of activists at local level and higher-level European networking.
To help finance this ambitious programme, the ESTRO Cancer Foundation was launched at the anniversary conference, which should help ensure ESTRO can continue to play a dynamic and leading role in pushing forward the boundaries of cancer care in decades to come.
The European Society for Radiotherapy and Oncology (ESTRO) celebrated its 30th anniversary in London this year at a special conference that brought together its main regular events as well as introducing a new one, the ESTRO International Oncology Forum, which included 'the opportunity to review 30 years of radiation oncology in 30 hours.’
“You don’t usually have an anniversary clinical track at conferences – it was a unique chance to review the evidence-based medicine generated over the last 30 years and how it prepares us for the future,” says Jean Bourhis, ESTRO’s current president, and head of the radiation oncology department at the Institute Gustave Roussy in Paris.
Although the history of radiation oncology goes back much further, the society can certainly be proud of its achievements, which are chronicled in a book prepared for the occasion, ‘Three decades of ESTRO: a vision for cancer cure’. It details the desire of ESTRO’s founders, who had mostly trained in the US, to establish a more united front in Europe after they had witnessed divisions in specialties in America, and indeed there was an idea for a ‘European Society of Oncology’, integrating all disciplines. But the feeling prevailed that radiotherapy needed its own distinct voice, as medical oncologists began their rise, but they would also include allied disciplines such as radiobiology and medical physics.
There was the challenge too of distinguishing radiation oncology from the much larger community of radiology at a time when some saw radiotherapy as a dying specialty, as the era of chemotherapy started to take hold. After holding its second meeting at the European Association of Radiology’s conference in 1983, ESTRO went its own way in the following years.
Special mention is made of Emmanuel van der Schueren, widely recognised as a brilliant clinical scientist and the driving force behind ESTRO, first as executive secretary and then president, and also editor of the society’s journal, Radiotherapy and Oncology. A professor of radiotherapy at Leuven, Belgium, he died far too soon from cancer in 1998, but has left a lasting impact on European oncology.
Van der Schueren’s fellow ESTRO founders must be name-checked too, as they are also pivotal figures – Klaas Breur, Jerzy Einhorn, Michael Peckham and Maurice Tubiana – who together set in train an organisation that has built up a membership of close to 5000.
As befits a field that covers a wide territory, scientifically and clinically, there are now several regular meetings in addition to the main ESTRO conference, which is annual but takes place at ECCO every other year. There are biannual meetings for physics and for the GEC group (Groupe Européen de Curie-thérapie – a clinical trials meeting that merged with ESTRO in 1990).
More recently, ESTRO has started running PREVENT, on the side-effects of radiotherapy, and an event on novel targeted drugs and radiotherapy. And there is CERRO, an experimental radiation oncology meeting, as well new events on head and neck oncology and molecular imaging.
As Bourhis notes, meetings and the journal contribute to communication, one of three pillars that ESTRO is organising its work around. “We are growing our own meetings and also organising more with multidisciplinary partners,” he says, noting that working with other specialties is in his opinion still the most pressing issue at clinical level in Europe.
Pulling up standards
The second pillar, education, is particularly important because of the variations in quality in using increasingly complex equipment and regimens. Bourhis says ESTRO has been careful not to expand its courses too quickly so as not to compromise quality, but it now runs more than 30 courses both inside and outside Europe – twice as many as in 2005. Significant numbers of attendees come from eastern Europe, Africa and the Far East, he says, with about 40% from western Europe. It all adds up to some 3000 attendees and 200 teachers a year. ESTRO’s core curriculum has also recently been revised, and it has now been integrated into the national teaching programmes of countries such as the Netherlands and Spain.
E-learning is playing an increasing part in ESTRO’s education plans, adds Bourhis. The society has a platform called Eagle (ESTRO's application for global learning), for online tutored courses, which has so far been used for rectal cancer, with courses for breast and head and neck to come. Another offering, called Falcon, is a combined workshop/online platform for anatomic delineation and contouring, which aims to address one of the biggest and most unpredictable sources of error in radiation oncology. “At ESTRO 30 we also launched the ESTRO Fellow, a position that people can attain after gaining a certain number of credits and passing an exam,” says Bourhis.
The third pillar of ESTRO’s work is policy, which Bourhis says has probably been the most challenging for all cancer societies in Europe, but which has received a big boost now that ECCO is more effectively presenting a joint front.
ESTRO past-president Michael Baumann, whose contribution to the field of radiation oncology was profiled in Cancer World Jan–Feb 2006, is the current president of ECCO. He and other ESTRO leaders have been uncompromising in fighting ESTRO’s corner in European oncopolitics, but it has been tough to gain the level of representation they feel the society needs within ECCO, and also politically on the European stage.
The level of investment needed by healthcare systems in radiotherapy is much higher than most other medical treatments, and ESTRO is acting once again to raise awareness of the economic benefits of its specialty, recognising that awareness of radiotherapy remains poor among not only the public and politicians, but also healthcare purchasers. A new project called HERO (Health Economics in Radiation Oncology), run by a taskforce from Europe and Canada, has started to look at the need for radiotherapy, its provision and accessibility, waiting lists, staffing, cost accounting and economic evaluation.
Taskforce member Yolande Lievens, from Leuven, explains that the project is an extended update of a 2005 study that was funded by the European Union called QUARTS (Quantification of Radiotherapy Infrastructure and Staffing). The radiation oncology community has still “barely started” evaluating the economic aspects of its treatments, she says, while other disciplines such as medical oncology have been doing better for some time.
ESTRO is acting once again to raise awareness of the economic benefits of its specialty
Aims of the HERO project include the development of economic models to calculate the value for money of treatments, and using data for lobbying and policy making. Preliminary data from a questionnaire were presented at ESTRO 30, with final results expected in 2013.
A very wide agenda
ESTRO has one of the widest agendas of any cancer specialty, covering as it does, for example, core European curricula for clinicians, physicists and radiotherapy technicians. This, together with the various meetings and educational activities, makes it quite a challenge just to organise its own affairs, let alone tackle the wider multidisciplinary integration that Bourhis says is vital.
A long list of actions are in train to address issues such as increasing membership and attracting younger members – the society would like to increase its number to 8000 by 2015, which would still be only about half of its target ‘market’. Like other European oncology organisations, however, it faces the tricky problem of whether and how to extend terms to national radiation oncology societies. Representing more of the various sub-specialties at board level is another issue, as is forging ethical collaboration with industry – the society has recently expanded its corporate membership programme, and now offers a ‘gold level’ whereby companies can participate in an advisory corporate council for promoting research and education.
ESTRO has certainly made a concerted effort to increase its profile and professional presentation, with the 30th conference being a flagship, and has engaged top-level public relations support, produced the anniversary book, created the new fellowship and started additional activities. With a solid platform in conferences and education, the emphasis is now on pushing forward its standards and guidelines in the multidisciplinary context, which will need both consistent engagement of activists at local level and higher-level European networking.
To help finance this ambitious programme, the ESTRO Cancer Foundation was launched at the anniversary conference, which should help ensure ESTRO can continue to play a dynamic and leading role in pushing forward the boundaries of cancer care in decades to come.
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