ESTRO 2024 - Abstract Book

S5459

RTT - Patient care, preparation, immobilisation and IGRT verification protocols

ESTRO 2024

578 studies were identified, and 108 duplicates were removed. 470 records were title-screened, resulting in 87 being sought for abstract review (Image 1). Review using eligibility criteria resulted in 37 full texts being screened by two researchers. Following quality assessment, 15 of 17 studies identified were included (Table 1). Kidney motion data was accurately recorded in 8 studies. From these studies, the mean kidney motion recorded for cranio-caudal (CC) ranged between 0.6-1.7cm (mean 1.02cm, median 0.83cm) and 0.68-2.45cm (mean 1.14cm, median 0.9cm) for the left and right kidney respectively (see Table 1). Lateral and anterior/posterior motion was minimal. Kidney motion varied more notably with left sided, superior pole tumours on 4DCT (n=7) and had higher variation within an ultrasound study (n=1). The positioning equipment used in the studies included Dual Vacuum BodyFix VacBag (Elekta, Stockholm) (n = 4), abdominal compression paddle (ACP) (n=1) and abdominal compression belt (ACB) (n=2). There was no data on patient comfort on AMM or PMM techniques for RCC SABR or how patients tolerated AMM techniques.

Conclusion:

Kidney motion can vary considerably in the CC direction; hence PMM, such as 4DCT, is essential for RCC SABR. Due to minimal data regarding AMM equipment (n=7), assessment of their effectiveness at minimising RM was not feasible. RM management strategies should be individualised. PMM inclusive of 4DCT, can aid personalised assessment of kidney motion to establish whether further AMM is required. The extent of management should be assessed based on laterality, dose/fractionation, and degree of CC kidney motion whilst in FB.

Further prospective research is required to evaluate comparisons of efficacy with different PMM and AMM techniques in RCC SABR and should be designed in collaboration with patient advocates. Patient comfort and compliance should