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Personalizing Medicine: Adapting to the Individual


K Brock

J Balter

M Joiner
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P Kupelian

K Brock1*, J Balter2*, M Joiner3*, P Kupelian4*, (1) Princess Margaret Hospital, Toronto, ON, (2) Univ Michigan, ANN ARBOR, MI, (3) Wayne State Univ, Detroit, MI, (4) David Geffen School of Medicine at UCLA, Los Angeles, CA

MO-D-217BCD-1 Monday 2:00:00 PM - 3:50:00 PM Room: 217BCD

Personalizing medicine through patient-specific adaptation is quickly moving from retrospective research to clinical implementation. The commercial availability of clinical tools, including auto-segmentation, deformable registration, and dose accumulation, is enabling these techniques to be utilized more efficiently. Understanding the importance, rationale, and consequences of anatomical and physiological based adaptation is paramount for the safe implementation of these techniques. This includes accounting for radiobiological differences in delivered dose and the impact that this may have on tumor control and normal tissue response.

This interactive session will highlight the evidence and rationale for anatomy-based adaptation, including retrospective studies from several anatomical sites indicating the uncertainties between the planned and delivered dose and the benefits achievable through adaptation. Translation of these techniques into the clinic will be discussed. The growing use of functional imaging enables more sophisticated adaptation and personalization of the treatment plan based on an understanding of the individual response of the tumor and normal tissue to radiation. Methods to understand and incorporate this information into the patient treatment plan will be discussed. The radiobiological impact of dose accumulation methods and adaptive strategies is often overlooked. Biological factors and their influence on these adaptive strategies will be addressed. The clinician’s perspective will also be highlighted, including the benefits of dose accumulation, personalization, and adaptation for the patient and the impact that this technology may have on clinical trials and outcomes assessment.

Learning Objectives:
- Understand the need for anatomy-based adaptation and methods to safely implement this in the clinic.
- Recognize the need for physiological-based adaptation and methods to safely implement this into the clinic
- Appreciate the radiobiological limitations and concerns associated with dose summation, and adaptation
- Describe the clinical implications of dose summation and adaptation on individual patient treatments, clinical trials, and outcomes assessment


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