title: The use of a standardized positioning support cushion during daily routine of breast irradiation.
abstract: OBJECTIVE
  The use of positioning and immobilization techniques during external beam irradiation of the female breast is time consuming and expensive. The currently available standardized positioning devices are insufficient. For this reason, we designed a new and generally useable hard foam positioning support cushion for the use during breast irradiation, and tested its clinical usefulness in a prospective study.
  
  
  METHODS
  Fifty-five female breast cancer patients receiving adjuvant radiotherapy following breast-conservative surgery were irradiated either without immobilization (n = 27) or with the positioning support cushion (n = 28). The time necessary for patient setup, the lying subjective comfort and--comparing portal images with simulator images--the reproducibility of the set up were determined.
  
  
  RESULTS
  Irradiation reproducibility was significantly improved (average deviation without positioning support cushion: 8.4 mm, with positioning support cushion: 6.1 mm, p < 0.001). The time required for the positioning of the patient with positioning support cushion was in average 73 s, without cushion it was 55 s. A significantly higher proportion of patients (72%) found the position with the positioning support cushion as pleasant, whereas only 46% of patients were pleased with the position without cushion.
  
  
  CONCLUSIONS
  The positioning support cushion designed in our department makes a substantial contribution to quality assurance in breast irradiation. It significantly increases the patients' comfort in a supine position. In contrast to conventional positioning and fixation aids it may be quickly and easily applied at low costs. Therefore, its use can be recommended.
authors.affiliation: Department of Radiation Oncology, J.W. Goethe-University, Frankfurt/Main, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Thilmann
authors.forename: I A
authors.initials: IA
authors.lastname: Adamietz
authors.forename: F
authors.initials: F
authors.lastname: Saran
authors.forename: S
authors.initials: S
authors.lastname: Mose
authors.forename: A
authors.initials: A
authors.lastname: Kostka
authors.forename: H D
authors.initials: HD
authors.lastname: Böttcher
mesh_terms: D001512:Bedding and Linens; D001943:Breast Neoplasms / Q000532:radiotherapy*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007103:Immobilization; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant; D015203:Reproducibility of Results; D016683:Supine Position