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Patient Chair-Design Allows PBS-Adaptive-Treatments for All Major Indications in a Gantry-Less System

S Koren1,2*, Y Braude2, Z Tochner2, M Marash2, (1) Ziv Medical Center, Safed, Israel,(2) P-Cure Ltd., Shilat, Israel

Presentations

(Sunday, 7/12/2020)   [Eastern Time (GMT-4)]

Room: AAPM ePoster Library

Purpose:
P-Cure (Shilat, Israel) offers a unique small footprint synchrotron-based gantry-less IMPT. The system allows adaptive therapy with in-room 4D fan-beam CT simulator, and 2D fluorography verification at treatment position. Previously designed Lung and H&N chair allowed upper body treatment indications; pelvis and lower abdomen could not have been CT scanned nor treated.
A new chair design, mounted to the robotic positioning device, allows CT scanning from head-to-thigh. Here, we are demonstrating a new treatment modality for prostate as multiple treatment beam directions are applied.

Methods:
As the chair rotation is analog to gantry rotation, a pseudo arc can be delivered with image guidance at relatively short time. We have demonstrated planning and delivery for 3 and 19 fields prostate plan.

Results:
Conducting a plan with the new full body (head-to-thigh) chair yields a 100% coverage to the PTV. The femoral head and necks received 13.7 Gy mean doses. The rectum and bladder received 9.1 Gy and 5.4Gy mean doses respectively. The hot spot was found to be 104%.

Conclusion:
The new head-to-thigh chair showed clinical feasibility, allowing a multiple filed adaptive treatment with image guidance in relatively short time. A further investigation is carried on quantifying the clinical benefits. These benefits may be obtained from organ spatial location in seated position, in addition to small target and OAR inter fraction motion.

Download ePoster [PDF]

Funding Support, Disclosures, and Conflict of Interest: Author is consulting with P-Cure LTD

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