S2721
RTT - Patient preparation, immobilisation, and verification protocols
ESTRO 2026
Streamlining TBI Setup: Innovative Approach for Homogenous Delivery, Enhanced Reproducibility & improved efficiency in HSCT using Extended Technique. SARATH KUMAR, YASER HASSAN, AHMED BUSHEHRI, SHADY FADEL, IRFAN MOHAMMAD KHAN, DIVYASHREE NARAYANAN, JITENDRA SHETE, AMANY HUSSAIN BESHEIR, QURATHULAIN FAISAL, IRFAD MP, AFAF MOHAMMED ISMAIL, CHACKO VARGHESE, VIVEK MP, JOSEPH PAYNTER, AHMED MOSAAD, HAMDY SAKR RADIATION ONCOLOGY, KUWAIT CANCER CONTROL CENTRE, KUWAIT, Kuwait Purpose/Objective: Purpose:This study addresses TBI challenges in resource-constrained environments, aiming to enhance delivery, outcomes, and quality of life. The approach balances simplicity, efficiency, and accuracy, complementing advanced technologies like VMAT and Helical Tomotherapy, while ensuring reproducibility. A customized CT simulation and treatment setup streamlined TBI delivery, offering a practical, effective solution for centers with limited resources, ultimately elevating patient care, outcomes.Objective:To develop a standardized patient setup technique for TBI, ensuring accurate and reproducible treatment delivery.To optimize shielding accuracy by utilizing image verifying strategies, minimizing dose to organs at risk (OARs) and reducing treatment-related toxicities.To streamline the TBI treatment process, improving procedural efficiency with a team of dedicated and trained staffs and reducing treatment times.To provide a cost-effective and resource- efficient alternative to advanced radiotherapy technologies.To evaluate the clinical effectiveness of this approach, assessing patient outcomes, treatment position, and quality of treatment delivery. Material/Methods: Material/Methods:This retrospective study includes patients who received conventional fractionated TBI at Kuwait Cancer Control Centre (Jan 2023 - Dec 2025). Key components include:Extended couch overlay (196 cm, extended cranially to 40 cm) and folded-leg patient positioning for full-length scanning (up to 160 cm).Dedicated treatment couch with motorised movements (+/- 21 cm longitudinal, 30 cm + 15 cm bed thickness, 37 cm vertical column lift) for accurate patient positioning.Portal imaging verification (using CNERGY - Theraview imager) for shielding accuracy, with imaging values evaluated.Beam spoiler use (Perspex, 1 cm thickness) for adequate superficial dose coverage.Dosimetric comparison with VMAT- based TBI and OSLD measurements (average dose deviations of +/- 5% across anatomical regions) for evaluation.
Results:
Conclusion: Conclusion:The standardized TBI approach improved treatment efficiency and accuracy, comparable to VMAT-TBI. Treatment times reduced to 25-30 minutes (CT simulation) and 45-60 minutes (delivery). Imaging data showed average deviations: Skull + Thorax (5.85 cm), Abdomen + Pelvis (2.85 cm), and Foot (4.5 cm). OSLD readings were within ±5% for Umbilicus, Right Lung, Left Lung, Right Eye, and Left Eye. The technique achieved dose accuracy, efficient workflow, and
Made with FlippingBook - Share PDF online