USE OF PORTAL RADIOGRAPHY TO INCREASE ACCURACY OF DOSE DELIVERY IN RADIATION THERAPY

Abstract

Port films were acquired for all radiation therapy patients (n = 132) treated over a thirteen month period to 1] assist in initial treatment field set‐up on Day 1, 2] for quality assurance with a second port film taken on Day 7 of radiation therapy, and 3] as a means to document the radiation treatment field as a part of the patients permanent medical record. Port films were used for both patients treated with a definitive course of radiation (n = 97 patients), and those treated palliatively (n = 35 patients). The portal radiographs were valuable in terms of the initial set‐up, and to correct for any positioning or other errors at the time of the one week recheck. Changes were made, based on the initial port film on Day 1, in 53% and 57% of treatment fields for palliative and definitive radiation patients, respectively. The changes made in both definitively and palliatively irradiated patients were usually in field position, an increase in field size to include all of the tumor, or a decrease in field size to spare normal tissue. Fewer changes were necessary based on the Day 7 recheck port films, but these day‐7 rechecks are recommended for quality control. Based on the high frequency of changes introduced because of the initial port film findings, it is recommended that port films be incorporated on a routine basis in veterinary radiation therapy.