Program Information
Efficient Process for AccuBoost Planning and Treatment Delivery to Minimize Patient Compression Time
I Iftimia*, M Talmadge , P Halvorsen , Lahey Clinic, Burlington, MA
Presentations
SU-E-P-27 (Sunday, July 12, 2015) 3:00 PM - 6:00 PM Room: Exhibit Hall
Purpose: To implement an efficient and robust process for AccuBoost planning and treatment delivery that can be safely performed by a single Physicist while minimizing patient’s total session time.
Methods: Following a thorough commissioning and validation process, templates were created in the brachytherapy planning system for each AccuBoost applicator. Tables of individual and total nominal dwell times for each applicator as a function of separation were generated to streamline planning while an Excel-based nomogram provided by the vendor functions as a secondary verification of the treatment parameters. Tables of surface dose as a function of separation and applicator, along with concise guidance documents for applicator selection, are readily available during the planning process. The entire process is described in a set of detailed Standard Operating Procedures which, in addition to the items described above, include a verbal time-out between the primary planner and the individual performing the secondary verification as well as direct visual confirmation of applicator placement using an articulated mirror. Prior to treatment initiation, a final time-out is conducted with the Radiation Oncologist. Chart documentation is finalized after the patient is released from compression following completion of the treatment.
Results: With the aforementioned procedures, it has been possible to consistently limit the time required to prepare each treatment such that the patient is typically under compression for less than 10 minutes per orientation prior to the initiation of the treatment, which is particularly important for APBI cases. This process can be overseen by a single physicist assisted by a dosimetrist and has been optimized during the past 16 months, with 180 treatment sessions safely completed to date.
Conclusion: This work demonstrates the implementation of an efficient and robust process for real-time-planned AccuBoost treatments that effectively minimizes the time that the patient is under compression.
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