UNUSUAL POSITIONING WITH THE ALPHA CRADLE® BRAND PATIENT REPOSITIONING SYSTEM
Marcia L. Alonso
Mario Branco, DGC
Susie A. Romano
Rosana T.R. Anselmo
Regina G. Lopes
Hospital Israelita Albert Einstein
Sao Paulo, Brazil
A 75 year old female patient with severe sifosis was diagnosed with carcinoma of the left breast and underwent a mastectomy. Due to the cifosis she was initially unable to be positioned on her back during the radiation therapy process (Fig. 1).
Fig. 1 Patient
The most accurate position for treatment was the dorsal/supine position with the left arm at 90°. In order to compensate for the patients back curve and neck angle we used the ALPHA CRADLE® brand Patient Repositioning System and as a result achieved the accurate position of treatment.
It was essential that we achieve the dorsal position in order for the patient to be placed within the field of radiation limits. The field of treatment indicated irradiation of the supraclavicular region and chest. The chest had to be irradiated by electrons. The positioning of the patient had to respect the limits of the radiation field, the use of electrons cones and the alignment.
THE TECHNIQUES
Put the plastic bag on the BF3L form, introduce the foam inside the bag, spread the foam more to the right side of the patient which is not affected.
Position the patient adequately, aligning with the help of the lasers. This kind of procedure was done in the simulation room.
As the patient was unable to lie flat, her head was held until the foam took the position. After the form was completed we positioned her head correctly to get the right shape.
After completing this process the Styrofoam® was removed and what was left looked like a very small sofa in shape (Fig. 2, 3, 4). Following the creation of this perfect reproduction, the patient was put in a sitting position with the ALPHA CRADLE® form right at her back and was now able to lie down with some assistance (Fig. 5).
Fig. 2 Frontal View
Fig. 3 Right side
Fig. 4 Left side.
Fig. 5 Positioning
The success of the treatment was due to the ALPHA CRADLE® form construction. Without the ALPHA CRADLE® form it would have been impossible to facilitate the positioning of the patient and ultimately the treatment process.