Cranial Immobilisation — Is There A Better Way?

Abstract

Westmead Radiation Oncology Department like many radiation therapy department's has high demands on staffing and equipment resources within the mould room, while continuing to combat a dramatically increasing waiting list. The radiation oncologist at Westmead specialising in cranial irradiation instigated the formation of a research group to explore the most resource effective and accurate way of stabilising cranial patients and to confirm whether the cranial immobilisation protocols already in practice within the department are suitable. Westmead Radiation Oncology employs four methods of cranial immobilisation; fixed and removable head frames that are used for stereotactic radiosurgery (SRS) and rigid plastic (uvex) and thermoplastic (orfit) casts. The latter two are used for brain lesions and head and neck treatments. With the advent of Intensity Modulated Radiation Therapy — IMRT, and modern day treatment, the field parameters employed are becoming smaller and the shielding more complex as the avoidance of critical organs which may be in the beams pathways is crucial. The necessity for rigid immobilisation and reproducibility on a daily basis is apparent.