THE USE OF A STANDARDIZED POSITIONING SUPPORT CUSHION DURING DAILY ROUTINE OF BREAST IRRADIATION

Purpose: The use of positioning and immobilization techniques during e xternal beam irradiation of the female breast is time consuming and ex pensive. The currently available standardized positioning devices are insufficient. For this reason, we designed a new and generally useable hard foam positioning support cushion for the use during breast irrad iation, and tested its clinical usefulness in a prospective study. Met hods and Materials: Fifty-five female breast cancer patients receiving adjuvant radiotherapy following breast-conservative surgery were irra diated either without immobilization (n = 27) or with the positioning support cushion (n = 28). The time necessary for patient setup, the ly ing subjective comfort and - comparing portal images with simulator im ages-the reproducibility of the set up were determined. Results: Irrad iation reproducibility was significantly improved (average deviation w ithout positioning support cushion: 8.4 mm, with positioning support c ushion: 6.1 mm, p < 0.001), The time required for the positioning of t he patient with positioning support cushion was in average 73 s, witho ut cushion it was 55 s, A significantly higher proportion of patients (72%) found the position with the positioning support cushion as pleas ant, whereas only 46% of patients were pleased with the position witho ut cushion. Conclusion: The positioning support cushion designed in ou r department makes a substantial contribution to quality assurance in breast irradiation. It significantly increases the patients' comfort i n a supine position. In contrast to conventional positioning and fixat ion aids it may be quickly and easily applied at low costs. Therefore, its use can be recommended. (C) 1998 Elsevier Science Inc.