Immobilization and treatment of patients receiving radiation therapy for extremity soft-tissue sarcoma

The treatment of extremity soft-tissue sarcoma has evolved considerably over the years. Previously, the preferred treatment was radical resection or amputation. Recently, radiation therapy combined with conservative resection has been shown to provide adequate tumor control while preserving a functional limb. Often, a large volume of tissue is irradiated in a manner that requires the patient to be in a reproducible position. Minimizing patient movement is imperative to ensure that the prescribed dose is delivered to the designated target volume. At our institution, Alpha Cradles have been routinely used for eight years to aid in positioning extremity sarcoma patients. The positioning of the patient for tumors at different locations in the extremity and the Alpha Cradle fabrication is described. The positioning device is comfortable for the patient and the accuracy is verified by comparison of simulation films with weekly port films.