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Improvement in total positioning error for lateral prostatic fields using a soft immobilization device

C Catton¹, L Lebar, P Warde

¹Department of Radiation Oncology, The Princess Margaret Hospital and The University of Toronto, Canada.

Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology

|October 23, 1997

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A rigid table insert did not improve patient positioning during prostate radiation therapy. However, soft leg immobilization significantly reduced positioning errors, improving treatment accuracy.

Area of Science:

Radiation Oncology
Medical Physics
Radiotherapy Technology

Background:

Accurate patient positioning is crucial for effective radiation therapy.
Prostatic irradiation requires precise targeting to minimize dose to surrounding tissues.
Assessing and reducing positioning errors are ongoing challenges in radiotherapy.

Purpose of the Study:

To prospectively measure total patient positioning error in lateral pelvic fields during prostatic irradiation.
To evaluate the impact of a rigid table insert on positioning accuracy.
To assess the effect of soft immobilization on reducing positioning errors.

Main Methods:

Prospective study of 61 patients undergoing radical prostatic irradiation.
Measurement of isocenter deviations using lateral portal films compared to simulator films.

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Patients were grouped into three cohorts: standard couch, rigid insert, and rigid insert with soft immobilization.

Main Results:

A rigid 1 cm polycarbonate insert showed no significant effect on reducing positioning errors.
Soft immobilization of the lower legs significantly reduced overall mean deviation from 3.9 mm to 2.6 mm (P=0.002).
Immobilization decreased both random and systematic positioning errors and reduced setup errors >5 mm from 17% to 8%.

Conclusions:

Stiffening the treatment couch with a rigid insert does not improve patient positioning accuracy.
Inexpensive soft immobilization devices can significantly reduce total patient positioning error in radiotherapy.
Soft immobilization offers a practical and effective method to enhance treatment precision for prostatic irradiation.