S2708
RTT - Patient preparation, immobilisation, and verification protocols
ESTRO 2026
EBRT as their first-line treatment were identified by a clinician. The first 20 were allocated to the control arm (cups) and the latter 20 to the experimental arm (water bottles). Pre-treatment hydration success was assessed through the number of appointments needed to achieve a usable scan. On-treatment bladder volume consistency was assessed by measuring craniocaudal and anteroposterior bladder dimensions on treatment CBCTs; for each patient and direction, inter-fraction variability was summarised as the per-patient standard deviation (SD) across fractions, and groups were compared using the Mann– Whitney test. Patient experience was assessed via a questionnaire covering experience/understanding, and thematic analysis was performed on qualitative feedback. Cost and environmental analysis compared disposable cup usage against water bottles. Results: Pre-treatment hydration outcomes showed no significant difference between groups (mean pre- treatment visits: control 1.20 vs bottle 1.15; p > 0.05). On-treatment bladder volume was more consistent with water bottles, with lower between-fraction variability: craniocaudal median per-patient SD 1.87 mm (IQR 1.60–2.18) vs 2.22 mm (1.93–2.63); Mann– Whitney p = 0.0066; anteroposterior 2.75 mm (2.28– 3.04) vs 3.17 mm (2.79–3.57); p = 0.0098. Means±SD across patients were 1.93 ± 0.42 vs 2.31 ± 0.47 mm (CC) and 2.72 ± 0.49 vs 3.19 ± 0.54 mm (AP). Patient surveys showed high understanding of the hydration process in both groups, but thematic analysis revealed confusion over drinking volume among patients who used cups. Patients found bottles more practical for treatment preparation and hydration. Financial modelling suggested higher costs for water bottles when assuming single cup use per fraction (£436.80 vs £650), but lower costs if patients used >1 cup (£873.60 vs £650). Environmental modelling estimated 10,920 paper cups used annually (equivalent to 665 kg CO ₂ emissions), compared with reusable bottles which avoided this waste.
Conclusion: Standardised water bottles improve bladder reproducibility, enhance patient experience, and reduce environmental and financial burden. Their implementation has the potential to improve treatment accuracy and align radiotherapy practice with sustainability goals. References: [1] Department for Business, Energy & Industrial Strategy. (2022). Greenhouse gas reporting: conversion factors 2022. London: UK Government.[2] Environmental Audit Committee: House of Commons. (2017). Disposable Packaging: Coffee Cups. London: UK Government.[3] Intertek. (2020). Frugalpac Coffee Cup Life Cycle Assessment Analysis. London: Intertek. Keywords: Prostate, hydration Setup Reproducibility of a Radiotherapy-Dedicated Bra in Patients with Large and Pendulous Breasts: A Prospective CBCT-Based Evaluation Ilaria Andreotti 1 , Valerio Pisoni 2,1 , Tiziana Brandolese 2 , Elena Ierman 2 , Donatella Longobardi 2 , Elisabetta Lo Russo 2 , Michela Maggioni 2 , Angela Screda 2 , Denise Vassena 2 , Valeria Faccenda 3,1 , Riccardo Ray Colciago 1 , Sara Terrevazzi 2 , Stefano Arcangeli 2,1 1 School of Medicine and Surgery, University of Milan Bicocca, Milan, Italy. 2 (1) Department of Radiation Oncology, Fondazione IRCCS San Gerardo Digital Poster 1426 dei Tintori, Monza, Italy. 3 (2) Medical Physics Department, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy Purpose/Objective: In patients with large and pendulous breasts, achieving daily setup reproducibility during whole- breast irradiation is challenging due to breast deformation and displacement. The Chabner XRT® Radiation Bra was developed to improve positioning and reproducibility. This study aimed to quantitatively assess setup stability using daily cone beam CT (CBCT)
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