Journal of Carcinogenesis & Mutagenesis

Challenges in development and implementation of pneumatic abdominal devices in reducing craniocaudal motion of abdominal tumors for patients undergoing external beam radiation treatment/ stereotactic body radiation therapy

15^th Asia Pacific Oncologists Annual Meeting

September 05-06, 2018 Tokyo, Japan

Kumar Deepak, Arora Deepak, Anand Anil, Kaul Rakesh, Munjal R K and Patro Kartik

Max Super Speciality Hospital, India

Posters & Accepted Abstracts: J Carcinog Mutagen

Abstract:

Purpose: Abdominal compression is used to reduce cranio-caudal motion in abdominal cancers which helps in reduced ITVs and improved normal tissue tolerance. This advantage can help facility in introducing SBRT technique at very nominal costs. We already had been using mechanical compression devices at both locations effectively. Pneumatic devices were introduced to overcome technical limitations like assembly, ease of use, compression measurement, reproducibility etc. associated with mechanical devices. Material & Method: Pneumatic abdominal compression was made using an air bladder from blood pressure measurement instrument (Heine, German make). Position of the air bladder on abdomen was determined for its maximum efficacy. Its shape was determined by number of folds given to air bladder with or without compression plate (125x100 mm) if used. Daily reproducibility is assured by taking an impression of deflated air bladder on thermoplastic held in All In One (AIO , Orfit make) immobilization board. Pneumatic pressure is monitored through dial gauge and set in such a way that patient can feel its pressure and swallowing of breathing during simulation as well as during treatment. Under fluoroscopy reduction in CC motion is seen by observing difference in two sets of video images of diaphragm, ribs, mass or markers, one with air bladder deflated and second with air bladder inflated to known pressure. Results: 7 patients have been treated using this device at our institutes since its introduction. Mean CC motion of 18 mm (range 15-25 mm) was observed without compression and reduced mean CC motion of 10 mm (range 6-12 mm) when pneumatic compression was used. An effective reduction was observed in 90% of cases. Conclusion: Pneumatic abdominal compression device can be used effectively for reduction of CC motion in abdominal cancers radiation treatment. It can help in dose escalation due to reduced ITVs and reduced normal tissue toxicity.

Biography :

E-mail: deepak_rad@hotmail.com