RESUMO
PURPOSE: Increasing number of heavy cancer patients has created challenges in diagnostic imaging and radiation oncology. Practical weight limits of the equipment can become an obstacle both for imaging and treatment of these patients. Most magnetic resonance imaging and computed tomography (CT) tables' static load capacities are between 450 and 500 pounds, and linear accelerator tables can support similar weights depending on the type of the table and manufacturer. One recurring issue we encountered was failure of the treatment couch's longitudinal drive belt due to heavy patients' sudden movement. In several cases, snapping of the longitudinal drive belt occurred when the patient's weight was under 300 lbs (below the rated weight limit). Additionally, we observed vertical deflection of the couch when extended/cantilevered with heavy patients. The purpose of this work was to implement immobilization methods and safety devices for radiation treatment management of heavy patients in order to increase patient/provider safety, prevent treatment couch damage, and reduce treatment disruptions. MATERIALS AND METHODS: We created three safety devices for treatment management of heavy patients. Wooden brace and Scissor jack were used to lock the couch longitudinal axis (while the couch longitudinal drive was floated) during the setup of a heavy patient and absorb the mechanical impulse applied to the couch longitudinal drive belt. Wooden brace was built in house and positioned in between the wall and treatment couch to lock the longitudinal axis. Commercially available 10 in × 10 in scissor jack lift with adjustable height 3 ½ in - 13 in was modified to increase effectiveness and safety. An additional stand was created with adjustable height and rolling rubber wheels to support the couch when extended/cantilevered with heavy patients. RESULTS: Using these devices prevented the longitudinal belt from breaking and improved the patient/therapist safety at eight treatment sites within our network. No farther couch belt failures were observed since devices were introduced for clinical use. All three devices can be used and removed without any modifications done to the treatment couch.
