CN7 Improved staff ergonomics and time efficiency using surface guided radiotherapy for prostate setup

Abstract

The use of surface guided radiotherapy (SGRT) for prostate patients with internal gold markers was investigated in this study. The purpose was to investigate the effects on ergonomics for the oncology nurses using the SGRT system for initial patient setup. Also, the time efficiency was evaluated using an automatic couch shift function. A total of 40 prostate patients with gold markers were included, 20 patients using the SGRT system CatalystTM (C-rad Positioning AB, Uppsala, Sweden) for patient setup and 20 reference patients using tattoos’ and laser alignment. At the first treatment fraction, the lateral laser was used to control that the patient was centered on the couch for all patients. For the SGRT patients, a colour map was projected onto the patients’ skin for guidance of posture correction. The calculated couch shift was automatically applied using an auto-couch function. Daily orthogonal kV-images were used for final positioning of the internal gold markers. For comparison purposes, 184 fractions using SGRT, and 192 fractions using laser alignment was included. The staff ergonomics was evaluated using a questionnaire that was sent out to ten oncology nurses. The result from the questionnaire showed an improvement in the staff ergonomics. Working with the colour map reduced the amount of heavy lifting for patient adjustments. It was reported that the pain in the neck, shoulders, elbow and thumbs was decreased from all the participators. These ergonomic effects were evaluated during a relatively limited time, suggesting that long term use of SGRT could have a great impact on the staff ergonomics. For most treatment fractions, the SGRT system improved the time efficiency compared to laser alignment (Figure 1). However, during the first treatment fraction an increased setup time was observed (median 3 min) due to time for camera optimization and learning the SGRT system. The treatment staff experienced an ergonomic benefit using the colour map projected onto the patients’ skin. Shorter patient positioning times were observed using SGRT for most treatment sessions. The result of this study led to implementation of the SGRT workflow for all prostate patients with internal markers in our clinic.