S2701
RTT - Patient preparation, immobilisation, and verification protocols
ESTRO 2026
effectiveness, efficiency, and patient feedback on the use of the rectal catheters.
were not significantly different between the two systems (13.6 vs 13.1 minutes, p=0.58).The conformal design of VB provided enhanced rotational control without increasing setup duration. Conclusion: Both immobilization systems provided effective stability for prostate proton therapy with similar translational accuracy. VB offered superior rotational control, particularly in minimizing roll and yaw deviations, and is recommended when enhanced rotational stability is prioritized without added setup time. References: 1. Malone S, Szanto J, Perry G, Gerig L, Manion S, Dahrouge S, et al. A prospective comparison of three systems of patient immobilization for prostate radiotherapy. Int J Radiat Oncol Biol Phys. 2000;48(3):657–65.2.Trofimov A, Nguyen PL, Efstathiou JA, Wang Y, Lu HM, Engelsman M, et al. Interfractional variations in the setup of pelvic bony anatomy and soft tissue, and their implications on the delivery of proton therapy for localized prostate cancer. Int J Radiat Oncol Biol Phys. 2011;80(3):928–37.3. Virkar M, Kumar N, Chadha P, Rodrigues R, Kharde A. Vacuum and thermoplastic mould-based immobilization systems used in patient undergoing pelvic radiation therapy: a comparative study. Int J Clin Biomed Res. 2020:8–10. Keywords: Proton therapy, Immobilization, Vacuum bag, HipFix Digital Poster Highlight 672 The use of a rectal catheter in patient-specific management of rectal gas in pelvic EBRT Esther Suliali Radiotherapy, Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, Rickmansworth, United Kingdom Purpose/Objective: Rectal gas can compromise treatment accuracy, increase toxicity and restrict planning dose constraints during external beam radiotherapy (EBRT) for prostate and gynaecological cancers. Unresolved rectal gas not only has dosimetric impact but also leaves patients frustrated, anxious and distressed as they attempt to pass gas naturally, sometimes without success. If unsuccessful in passing gas naturally, this can result in gaps in radiotherapy treatment or delays in pre- treatment scan hence negatively impacting cancer wait targets. Due to this being a recurrent issue, our department introduced the use of a rectal tube catheter (shown in Figure 1) as a patient-specific innovation to help get rid of gas in patients who couldn’t do it naturally. This study evaluates the
Material/Methods: Following approval from the departmental ethics committee, a retrospective review of 60 treatment fractions was conducted in our department (30 catheter use, 30 natural passages). For rectal catheter use, when presence of rectal gas that interfered with treatment delivery was noted on CBCT imaging, a rectal tube catheter was inserted into rectum for roughly one minute to allow degassing. For the natural passing method, the patients were instructed to use the toilet to allow natural passage of gas. Following either intervention, a subsequent CBCT was acquired. Effectiveness was defined as successful rectal gas resolution enabling treatment (as shown in Figure 2). Efficiency was measured as time from intervention to successful treatment delivery. Patient feedback on acceptability, frustration, and reassurance was reviewed. Statistical analysis was performed using the Mann–Whitney U test.
Results: Catheter use in comparison to natural passage, significantly reduced time to treatment (median 11 minutes vs 32 minutes, p = 0.00012), providing greater efficiency. Success rates were similar (73% catheter vs 80% natural). Patients reported that when natural passage was unsuccessful, the catheter was invaluable in preventing prolonged hospital stays, reducing frustration, and ensuring treatment could proceed without interruption. Conclusion:
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