“Learning From Every Patient” – Countdown for the Next Congress of the European SocieTy for Radiotherapy and Oncology (ESTRO)

Monica-Emilia Chirilă: 1. What was the reason you chose to become an ESTRO member in the first place, and what prompted you to become more involved in ESTRO activities? I first became a member of this organization in order to attend the ESTRO 2006 Congress in Leipzig where I presented a poster on outcomes in head and neck cancers. As it happened, that meeting changed my career: I met Professor John Yarnold, who persuaded me to start a fruitful partnership in breast radiotherapy research, highlighting the value of networking at the annual congress! A few congresses later, with a research degree in breast radiotherapy under my belt, and appointment to the Royal Marsden as a consultant, I attended the ESTRO Breast Multidisciplinary Course in Athens in 2010 where I met many of the European colleagues with whom I have since collaborated, learning first-hand how ESTRO can facilitate sharing expertise, development of protocols and guidelines, and practice-changing randomized controlled trials. I was invited to join the Scientific Committee for ESTRO 35 in Turin where I learned how a program comes together and, in 2017, I joined the Editorial Board for the Journal of Clinical and Translational Oncology (ctRO, https://www.ctro.science/) through which I’ve seen how a journal grows. In 2019 I was elected to the ESTRO Board and I was only just starting on the road of discovering more about the inner workings of ESTRO when, in April 2020, I became the Society’s President-Elect. It’s been a steep but enjoyable learning curve ever since. If I had to sum up what kept attracting me back to ESTRO it is the fact that it’s a family of individuals working enthusiastically towards the same goal of improving outcomes in patients being treated with radiation therapy. ESTRO has an irresistible energy and momentum.

Monica-Emilia Chirilă: 2. What is your vision regarding the future of ESTRO policies and the directions the Society should follow? Well, the focus of my presidential candidacy statement was around facilitating implementation of innovations for immediate benefit to patients throughout Europe and beyond. Of course, there are already many initiatives from HERO, (https://www.estro.org/Science/ Activities/HERO) to the Marie-Curie Campaign, (https://mariecurielegacy.org/) to the ESTRO-EORTC E2-RADIatE platform studies (https://www.estro.org/Science/Activities/ E2RADIATE) that move us towards appreciating the ESTRO 2030 vision- “Optimal radiotherapy for all”. What we could do better is to broaden the pool of volunteers involved in ESTRO activities and discussions on how to effect this are underway.

Monica-Emilia Chirilă: 3. What were the challenges you faced during the COVID-19 pandemic – as a clinician, as part of the ESTRO leadership, and the organizing committee of the annual Congress? March 2020 is still so vivid in my memory. I remember clearly the day I was asked which of my several dozen breast patients’ radiotherapy planning pathways I didn’t want to pause? My reaction then was “Until when?” Mercifully, a few of us were already aware of the results of the FAST-Forward fractionation study such that we were able to switch many patients to a fivefraction schedule, and get them through and out before the pandemic really took hold. The peerreview manuscript was prepared rapidly to provide a strong foundation for what has become a durable change in the standard of care. Without this transition, who knows how our radiotherapy departments would have survived the pandemic?

Joining the ESTRO leadership team during a global pandemic has been a little daunting, but the ESTRO Office handled the postponement of ESTRO 2020 brilliantly under the ever-evolving circumstances. Decisions around ESTRO 2021 were, if anything, more challenging, as there was more than one feasible option. As a leadership team, I think we are all delighted that the live meeting went ahead, providing many colleagues with their first opportunity to meet face-toface in well over a year. The hybrid aspects worked well too, and we will be incorporating the feedback as we move ahead to ESTRO 2022. It seems likely that, whilst prioritizing the networking aspects of face-to-face meetings, the hybrid aspects will stay, allowing many more individuals to access the scientific and educational content of the programs.

Monica-Emilia Chirilă: 4. The ESTRO 2030 Vision is represented by “Radiation Oncology, Optimal Health, For All, Together”. How was this new statement adopted, and how do you envision its translation into practice? The ESTRO 2030 vision was developed during a meeting in Mechelen in February 2018, before I joined the Board and I can’t give you any “behind the scenes” details on how the vision statement evolved. That said, I think the statement “Radiation Oncology, Optimal Health, For All, Together” succinctly and clearly summarizes ESTRO’s vision. Radiation Oncology is our area of interest and expertise, we want to achieve the best possible outcomes in terms of cancer-free survival with minimum toxicity, we want these outcomes to be available to all patients regardless of where they live, and we want to work together – the RT community, with a multidisciplinary approach, and with all stakeholders involved – to make this possible. ESTRO will continue to prioritize the underpinning science through its congresses, translating research findings into practical recommendations for the clinic through guidelines and educational activities, bringing different disciplines and geographies together through all the aforementioned activities, and working with all stakeholders, including patients, and those involved in healthcare policy, to effect change at healthcare systems levels.

Monica-Emilia Chirilă: 5. What main challenges do you see in achieving ESTRO’s strategic priorities, and how will you overcome them? The obvious current challenge to our day-to-day working practices is the ongoing pandemic, albeit I think human beings, especially those involved in ESTRO, are remarkably adaptable and, in the virtual/ hybrid world ESTRO’s reach can potentially be greater with lower resource requirements. Other current challenges include integrating/ implementing innovations into our healthcare systems. These systems are different for each country and region and we need to continue the dialogue with national societies in particular to understand how the ESTRO community can help.

Monica-Emilia Chirilă: 6. How is ESTRO involved in training and supporting the young Radiation Oncologists? Just as I was attracted to ESTRO by the congresses and educational activities, these remain a great starting point for trainees to observe, learn and network. yESTRO, the young ESTRO committee, has since been formed and does a tremendous job engaging our younger members through the dedicated Congress track, whose program can be tailored to the specific needs and interests of younger members. It is important that we keep the next generation engaged and active in all ESTRO activities from committees to course faculties, as well as facilitating younger members being active in their own institutions and communities. One way to facilitate this is the ESTRO mentoring program, initially planned for 2020 and finally started in 2021, and led by yESTRO along with the Education Council. It is hoped that the CERRO meeting will also restart in 2023 as an annual workshop specifically designed for empowering and connecting future leaders. Membership is also an important channel through which younger members can participate in our community with a dedicated type of membership for professionals in training, alongside agreements with young national societies, to keep membership fees lower for those in training.

Monica-Emilia Chirilă: 7. Which opportunities does ESTRO offer for professionals from countries with a challenging economic background and developing Radiotherapy infrastructure? ESTRO is an inclusive society and welcomes involvement of any individual working in radiation oncology regardless of location and background. This said, ESTRO appreciates that different healthcare settings present different challenges for those who wish to either engage with ESTRO activities and/or improve the provision and delivery of radiation oncology in their home nation. In relation to education and training for professionals working in countries with a challenging economic background, special fees are set for both teaching courses and congresses to facilitate access, and there is scope to capitalize on the increasing use of the virtual environment and broaden the reach of ESTRO’s scientific and educational outputs.

Monica-Emilia Chirilă: 8. What about the next ESTRO meeting? What plans could you share with us regarding this important educational event? ESTRO 2022’s program is almost complete by the incorporation of the hundreds of abstracts submitted by our community. The theme is “Learning from every patient” and you can expect to see this aspect incorporated throughout the program. The other focus will be on coming together. We very much hope to build on the success of ESTRO 2022 and meet with as many colleagues as possible face-to-face whilst still providing content and value for those who are unable, for whatever reason, to join us in person.

Monica-Emilia Chirilă: 9. How do you manage to keep a life-work balance? This is a tough question to answer because I don’t really know what a perfect work-life balance is. What I do know is that time is a really precious commodity and I try to use it well by throwing myself wholeheartedly into whatever commitment is in front of me, being that a clinic, a talk, or connecting with my family. I know what my priorities are and I try to align my commitments accordingly (not always with complete success).

Monica-Emilia Chirilă: 10. We all face challenges in our day-to-day life. Where do you find sources of inspiration and motivation? It’s really important to me that we all try to live our best lives. Our time on this planet is so short and it’s folly to waste it on anything less than being fully alive, connected and present. Music and nature, particularly the sea, inspire me as do stories of human endeavour and impact. I am motivated by desires to make a difference, to get things done and to support those around me to make a positive difference to our world too. That all sounds rather intense now I’ve written it down. Whilst I can be very focused, those who know me well know that I also like to laugh… a lot. My husband is very, very funny, which is a godsend.