Abstract
THE PROBLEM Craniospinal irradiation (CSI) is a critically important technique in the treatment of several malignancies, in that coverage of the craniospinal axis contributes to cure in both the definitive [1,2] and salvage [3] settings. Although SI is traditionally described using hotons, theadventofnewprotonceners has opened opportunities for more atients to be treated with proton CSI. Most sources describe CSI perormed in the prone position [4,5]. upine CSI (SCSI) is preferable if ossible because it allows a uniform ource-to-skin distance for the spial field and is technically challengng [6]. Our proton center did not erform craniospinal therapy rouinely before July 2010, and we ished to offer CSI to our patients sing a supine technique. In August 2010, we instituted a peiatric SCSI program. This was in conunction with the development of a roton-specifictabletopattachmentfor atient immobilization [7]. Since that ime, 23 patients have been treated ithSCSI.For thefirst severalpatients, elected staff members received specialzed training and initially performed all CSI procedures, and our implemenation protocol required nursing and adiation oncologist presence in the reatment room for all setup maneuers. Over time, these policies were odified to allow all therapy staff embers to become certified to use the echnique, and physician involvement snowrequiredonlyfor imageapproval efore treatment of each field. Using the data from the Indiana niversity cyclotron control system, nd records of the IU Health Proton herapy Center, it is possible to assess
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call