S2753
RTT - Patient preparation, immobilisation, and verification protocols
ESTRO 2026
5 Health Professions Management, Michele and Pietro Ferrero Hospital - ASL CN2, Verduno (CN), Italy
the definition of verification periodicity (frequency) throughout the treatment course and is closely linked to the optimization (i.e., reduction) of planning margins. Moreover, continuous variability analysis, used to inform more objective decision-making, demonstrated a direct influence on safety margin determination and thus the potential to reduce unnecessary radiation exposure to surrounding healthy tissues.The findings of the present study should be aligned with future research aimed at identifying safety measures and barriers associated with each clinical scenario, in order to determine which metrics and quality indicators can support enhanced harmonization of clinical practices. Further investigation into emerging online and real-time technologies is also warranted to improve patient- specific motion management, addressing both intra- fractional and inter-fractional variations. References: Van Herk et al. The probability of correct target dosage: Dose-population histograms for deriving treatment margins in radiotherapy. IJROBP. 2000; 47(4):1121–1135Stroom JC, Heijmen BJ. Geometrical uncertainties, radiotherapy planning margins and margins. Radiother Oncol. 2002; 64:75-83De Boer HCJ, Heijmen BJM. eNAL: an extension of the NAL setup correction protocol for effective use of weekly follow- up measurements. IJROBP. 2007; 1586–1595Srinivasan K, Mohammadi M, Shepherd J. Applications of linac- mounted kilovoltage CBCT in modern radiation therapy: A review. Pol J Radiol. 2014 Jul 3;79:181- 93McNair HA, Franks KN, van Herk M. OnTarget 2: Updated Guidance for Image-guided Radiotherapy. Clin Oncol (R Coll Radiol). 2022 Mar;34(3):187-188 Keywords: Interfractional Errors, Off-line Protocols Digital Poster 4568 Implementation of a mobile application to support bladder and rectal preparation in patients undergoing prostate radiotherapy: preliminary experience Rachele Petrucci 1 , Erica Prato 1 , Simone Baroni 1 , Claudio Scaffidi 1 , Stefania Crivellari 2 , Manuela Alessio 2 , Giorgia Cavallero 2 , Nicola Padula 3 , Francesco Lucio 3 , Giusto Viglino 4 , Giancarlo Mercurio 5 , Luisella Canta 5 , Luca Delpiano 5 , Alessia Reali 1 1 Radiotherapy Unit, Michele and Pietro Ferrero Hospital - ASL CN2, Verduno (CN), Italy. 2 Projects, Research, and Innovation Unit, Michele and Pietro Ferrero Hospital - ASL CN2, Verduno (CN), Italy. 3 Medical Physics Unit, Michele and Pietro Ferrero Hospital - ASL CN2, Verduno (CN), Italy. 4 External Contributor, Telemedicine Expert, Verduno (CN), Italy.
Purpose/Objective: Bladder and rectal filling can significantly affect prostate position during radiotherapy. Maintaining consistent organ volumes between simulation and daily treatment sessions enhances treatment accuracy, reduces radiation-related side effects, and improves dosimetric quality. However, patient compliance with bladder and bowel preparation instructions is often variable. Telemedicine represents a promising approach to improve adherence and enable continuous remote monitoring.The purpose was to evaluate the feasibility and effectiveness of a mobile application designed to support patients undergoing prostate radiotherapy, with the goal of optimizing bladder and rectal preparation and improving the overall quality of treatment. Material/Methods: A smartphone and tablet application was developed to provide personalized instructions, interactive reminders, and a feedback system on preparation status.The app operates through two main interfaces: Patient/Caregiver notifications and a Healthcare professional dashboard.Patient/Caregiver notifications: Each patient could assign a caregiver to receive “Memotherapy” reminders. For bladder preparation, two automated messages were sent:Message 1: Sent 30 minutes before the prescribed water intake time (default 15 minutes): “At [time], start drinking [volume] of water over [duration].” “Attention: remember to urinate before starting to drink.” (Audible message, 10 seconds).Message 2: Sent 30 minutes after Message 1: “Have you drunk all the prescribed water? YES/NO.” (Audible message, 15 seconds).For rectal preparation, the app automatically delivered visual and audible notifications according to the scheduled time. This reminder did not require patient confirmation.Healthcare professional dashboard: Patient responses were displayed using a color-coded legend:Gray: no response within 10 minutesRed: no response after 10 minutesFaded green: “Yes” response received between 5–10 minutesPatients recorded daily data on fluid intake and bowel activity before each treatment session. Radiotherapy technologists (RTTs) monitored the preparation status in real time and could intervene directly prior to treatment when necessary. Results: Use of the app resulted in increased adherence to pre- treatment instructions and a reduction in setup repetitions due to inadequate preparation. Patient satisfaction was high, with a positive perception of the digital support provided. Conclusion:
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