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Two-Year Experience On Uniform-WET Couch in Proton Therapy

A Goughenour, J Mccullar, G Maclennan, R Rahimi Darabad, F O'Grady*, C Bamberger, A Parniani, A Rao, J Fan, P Wang, Inova Health System, Fairfax, VA

Presentations

TU-F115-IePD-F6-2 (Tuesday, 7/12/2022) 1:15 PM - 1:45 PM [Eastern Time (GMT-4)]

Exhibit Hall | Forum 6

Purpose: There have been several designs of the patient supporting couch for proton therapy, such as “underneath-rail” design, “gradually-thinning” design and “uniform-WET” design. The unexpected WET change during the treatment could happen easily in the first two designs. Therefore our center picked the uniform-WET design couch when we started treating patients. The report here is to introduce our experience of using such couch in two years of treating patients. The commissioning result and issues/solutions are included.

Methods: The relative stopping powers (RSP) of every material constructing the couch were measured and couch templates were built in the treatment planning system which were then inserted into plans according to usage. The WET of couch at different locations were checked for consistency. As the standard couch for head and neck (H/N couch) was too short for some patients receiving central nerve system irradiation (CSI), these patients were treated with a stacked H/N couch onto body couch (stacked couch) to increase the clearance. The same solution was found useful for H/N/upper mediastinal cancer patients with head mask while performing breath hold treatment.

Results: The WETs of couch at different locations are found to be consistent. Therefore the location change of patient’s body relative to couch did not bring unexpected WET change in regions away from the couch edges. Using the “stacked” couch solution, six CSI patients and four head mask with breath hold patients have been treated successfully.

Conclusion: The uniform-WET couch was used successfully in our proton center. The proton ranges of posterior fields in clinically relative regions were consistent even with some changes between patient’s body and couch. With the design of the stacked couch, we developed a solution to overcome the issue of short H/N couch for successful, reproducible CSI and breath-hold treatments requiring a head mask.

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