VACUUM AND THERMOPLASTIC MOULD-BASED IMMOBILIZATION SYSTEMS USED IN PATIENT UNDERGOING PELVIC RADIATION THERAPY: A COMPARATIVE STUDY

Introduction: The aim of the present study was to compare two immobilization systems for comparison of setup errors in targeted radiotherapy.

Methods: Retrospective analysis was done for the patients undergoing radiotherapy from May 2012 to December 2018 at our institution. Immobilization was performed on 30 patients sessions (Vacuum cushion i.e., Vac-Lok™ = 15; Thermoplastic mould i.e., Pelvicast pelvic masks = 15). A total of 763 cone-beams were analysed. The target lesion location was verified by cone-beam computed tomography (CBCT) prior to each session, with displacements assessed by CBCT simulation prior to each treatment session. Systematic setup errors, random setup errors, isocenter deviations in the Medio-lateral (ML), Supero-inferior (SI), Antero-posterior (AP), Rotation (yaw) directions of the patient position was calculated.

Results: On comparing the Vac-Lok™ and Pelvicast pelvic masks group with respect to Systematic and random error in the lateral, longitudinal, vertical and YAW direction, no statistically significant difference was seen except the random error in YAW direction (P=0.037, Unpaired t-test). There was no difference observed in comparing the isocentric deviation.

Conclusion: It was inferred and concluded that using a vacuum cushion for pelvic radiotherapy provides no added benefit compared to using a thermoplastic mould. Thermoplastic mould is recommended for patients receiving pelvic radiotherapy to improve overall reproducibility.
Keywords: Rotational therapy; Radiotherapy; Systematic, random error; Thermoplastic mould; Vacuum cushion.