S2749
RTT - Patient preparation, immobilisation, and verification protocols
ESTRO 2026
comprehensive scoping review of tattoo-less techniques in radiation therapy. Crit Rev Oncol Hematol.2024;204:104518.(4) Fidarova, E et al. Measuring global inequity in radiation therapy: Resource deficits in low- and middle-income countries without radiation therapy facilities. Adv Radiat Oncol.2023;8(1),100043(5) McComas, KN et al. Online adaptive radiation therapy and opportunity cost. Adv Radiat Oncol.2022;8(3),101034 Keywords: Tattoo-free positioning, SBRT lung, radiotherapy Incorporating health literacy strategies to address barriers to effective communication of prostate radiotherapy preparation. Ita-Marie Dunne 1 , Laura Barry 2 , Una Cooper 1 , Tamryn Patrick 2 , Siobhan McCarthy 2 , Michelle Coonan 1 , Theresa Binz 2 , Heather Ryan 2 , Erica Bennett 2 1 UPMC Hillman Cancer Centre, UPMC Hillman Cancer Centre, Waterford, Ireland. 2 Bon Secours Radiotherapy Cork, in partnership with UPMC Hillman Cancer Centre, Cork, Ireland Purpose/Objective: Health literacy refers to an individual’s ability to find, understand, and use information and services to make health decisions. Low health literacy is associated with poor treatment adherence and ineffective Digital Poster Highlight 4407 communication between patients and healthcare professionals (HCPs) (1).A review of patient feedback from two radiotherapy departments identified communication and information gaps between patients and HCPs, regarding preparation for prostate radiotherapy. A Quality Improvement Project (QIP) was initiated to:Improve HCPs communication and education by recognising health literacy challenges. Reinforce patient education and the accessibility of information resources. Material/Methods: A visual aid was developed to explain the prostate radiotherapy preparation process. (figure 1) The existing Patient Information Leaflet (PIL) was reviewed and revised in line with the National Adult Literacy Agency’s (NALA) Plain English Writing and Design Tips to ensure accessibility for individuals with varying literacy needs. (2)Patients receiving radiotherapy for prostate cancer were invited to complete a five-point Likert scale questionnaire assessing their understanding of the preparation process, its rationale, and the clarity and usefulness of the visual aid. Radiation therapists (RTTs) completed a separate questionnaire evaluating self-assessment of
support on the treatment couch with lockbars. Rotational setup errors based on vertebral matching were collected. Group means (M) were calculated, with Welch’s t-test applied for comparison; systematic setup errors ( Σ ) assessed using Levene’s test and random setup errors ( σ ) evaluated with Mann– Whitney U-test, all performed in Python. Results: No statistically significant differences were found for sex, age, fractionation or tumor location (all p > 0.05). Rotational setup errors were comparable between groups (Table 1). No statistically significant differences were found in group means and in systematic or random setup errors (all p > 0.05).
Variability in Rz is greater in the tattoo-free group (Figure 1). Nevertheless, the difference in Rz is not statistically significant, indicating the null hypothesis cannot be rejected at 5% significance level based on current dataset.
Conclusion: The tattoo-free workflow shows a larger systematic setup error in Rz compared to the conventional tattoo- based workflow, although this difference was not statistically significant and had no clinical impact on SBRT treatments. This approach avoids drawbacks of tattoos and enhances patient comfort. However, for larger lung tumors and nodal metastases, additional data will be collected to determine whether these groups can be considered significantly equivalent and to assess clinical relevance of potential differences. Tattoo-free workflow applied in lung SBRT, with data collected for broader implementation. References: (1) Asada, H et al. Emotional experiences of skin markings among patients undergoing radiotherapy and related factors. Patient Prefer Adherence.2022;16,1359–69(2) Moser, RP. Radiotherapy tattoos: Women's skin as a carrier of personal memory. Breast J. 2020;26(8),1516–17 (3) Lastrucci, A et al. Advancing patient setup: A
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