Device and method for immobilizing patients for breast radiation therapy

• US 8,210,899 B2
• Filed: 11/20/2007
• Issued: 07/03/2012
• Est. Priority Date: 11/21/2006
• Status: Expired due to Fees

• Current Assignee: LOMA Linda University Medical Center (Mission Healthcare Services LLC)
• Original Assignee: LOMA Linda University Medical Center (Mission Healthcare Services LLC)
• Inventors: Bush, David A.
• Primary Examiner(s): HALE, GLORIA M
• Application Number:
  US12/515,523
• Publication Number:
  US 20100067659A1
• Time in Patent Office: 1,687 Days
• Field of Search: 450/92, 450/93, 450/39, 450/36, 450/37, 450/38, 600562-567, 600/411, 600/414, 600/417, 600/426, 600/427, 600/429, 600/439
• US Class Current: 450/54
• CPC Class Codes: A41C 3/00 Brassieres
• CPC Class Codes: A61B 6/0435 with means for imaging suspended breasts
• CPC Class Codes: A61N 2005/1097 Means for immobilizing the patient
• CPC Class Codes: A61N 5/10 X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy A61N5/01 takes precedence
• CPC Class Codes: A61N 5/1049 for verifying the position of the patient with respect to the radiation beam

Abstract

According to the improved systems and methods described herein, a patient may be immobilized so that one or both breasts are returned to a known position. Additionally, the improved systems and methods reduce respiratory movement of the breasts. Thus, the immobilization devices and techniques described herein provide accurate and reproducible breast positioning while simultaneously reducing respiratory motion.

Claims

1. A method of forming a support structure for immobilizing a patient in a prone position for delivery of radiation to at least one breast of the patient in a reproducible manner, the method comprising:

positioning a support brassiere on the patient, the support brassiere comprising a semi-rigid cup that is sized to engage a breast of the patient and a strap that is configured to fasten the semi-rigid cup to the patient;

positioning the patient, who is wearing the support brassiere, in a prone position generally within a full-body support structure so that the semi-rigid cup of the support brassiere is suspended above and proximate to, but not in contact with, an upward-facing surface of the full-body support structure;

with the patient positioned generally within the full-body support structure, introducing a non-caustic malleable substance into the full-body support structure generally under the patient and under and around the cup so that the substance substantially occupies a space between the upward-facing surface of the full-body support structure and the semi-rigid cup; and

hardening the non-caustic malleable substance while it substantially occupies the space under the patient and under and around the cup so that the non-caustic malleable substance becomes a substantially rigid breast immobilization device comprising;

a top surface having a generally concave contour therein corresponding with an impression of the semi-rigid cup; and

a bottom surface configured to engage with the up-ward facing surface of the full-body support structure;

the substantially rigid breast immobilization device thereby configured to generally conform to and be supported by the full-body support structure, the substantially rigid breast immobilization device, in turn, configured to support and immobilize the semi-rigid cup, which in turn is configured to support and immobilize the at least one breast of the patient.

2. The method of claim 1, wherein the non-caustic malleable substance comprises a two-part expandable foam, and hardening the non-caustic malleable substance comprises allowing the two parts of the foam to mix together.

3. The method of claim 1, wherein the semi-rigid cup comprises one or more plastic materials.

4. The method of claim 1, wherein the support brassiere comprises a compression material for compressing another breast of the patient.

5. The method of claim 1, wherein the non-caustic malleable substance comprises polymeric foam.

6. The method of claim 1, wherein the non-caustic malleable substance comprises a two-part foam.

7. A device for immobilizing a patient for delivery of radiation to a breast of the patient, the device comprising:

a full-body support structure configured to support a patient in a prone position wearing a brassiere comprising a cup and at least one strap, such that the breast to be treated is within the cup and suspended above the full-body support structure; and

a breast immobilization device comprising a substance configured to substantially fill the space between the brassiere and the full-body support structure and to have contours that substantially define a negative relief image of the cup, the breast immobilization device configured to be positioned on and engage the fully-body support structure.

8. The device of claim 7, wherein the cup comprises a portion of a support brassiere that is releasably secured to the patient.

9. The device of claim 7, wherein the device is configured for positioning the patient for delivery of radiation through the full-body support structure, through the brassiere, and through the breast immobilization device to a target area within the breast.

10. The device of claim 7, wherein the support structure comprises one or more of:

a pod and a table, or a pod combined with a table.

11. The device of claim 7, wherein the breast immobilization device is custom designed for engagement with the cup as it is oriented on the breast of the patient for treatment delivery.

12. A method of reproducibly immobilizing a patient for radiation therapy to the patient'"'"'s breast, the method comprising:

providing a brassiere having a cup for engagement with the breast of the patient;

a full-body patient support structure for supporting the patient during radiotherapy treatment, the full-body patient support structure comprising lateral sides configured to contain a breast immobilization device;

positioning a breast immobilization device on the full-body patient support structure, between the lateral sides and generally around the cup, the breast immobilization device comprising contours that are custom-fit to engage with the cup on at least one of a patient'"'"'s breasts; and

positioning the patient in a prone position on the breast immobilization device (which is on the full-body patient support structure), in a reproducible manner, so that the at least one breast engages with the contours of the breast immobilization device and the breast immobilization device engages with the full-body support structure.

13. The method of claim 12, wherein the support structure comprises a semi-hemispherical structure.

14. The method of claim 12, wherein the breast immobilization device comprises two-part foam positioned within the semi-hemispherical structure.

15. The method of claim 12, wherein the support structure further comprises one or more of a pillow, beanbag, foam structure, and vacuum cushion that are positioned to support the patient'"'"'s shoulders, abdomen, and/or pelvis.

20. The method of claim 12, further comprising forming the breast immobilization device before positioning the breast immobilization device on the full-body patient support structure, wherein forming the breast immobilization device comprises introducing a formable material between the full-body patient support structure and the patient while the patient is in a prone position and allowing the formable material to conform to a portion of the patient and a top surface of the full-body patient support structure.

21. The method of claim 15, wherein the one or more of a pillow, beanbag, foam structure, and vacuum cushion comprise at least one of the lateral sides.

22. The method of claim 12, wherein the lateral sides comprise at least one sidewall of the full-body patient support structure, wherein the at least one sidewall of the full-body patient support structure protrudes upwardly from an upwardly-facing surface of the full-body patient support structure.

23. The method of claim 20, wherein the formable material comprises foam and the lateral sides are configured to help contain the foam as the breast immobilization device is formed.

16. A system for immobilizing a patient for delivery of radiation to a breast of the patient, the device comprising:

a patient table configured to support a patient in a prone position with a breast to be treated located above and extending downward toward the patient table; and

a customized, contoured, upper-body immobilization device configured to be placed atop the patient table and to both support the upper body of the patient and to fit that particular patient'"'"'s contours and thereby immobilize the breast of the patient with respect to the patient table during delivery of radiation to the breast, thereby allowing for reproducible positioning of the patient and the breast for each of a plurality of radiotherapy treatments.

17. The system of claim 16, wherein the customized, contoured, upper-body immobilization device comprises substantially hardened two-part foam comprising a depression sized to receive and conform to the shape of the breast with the patient in a prone position.

18. The system of claim 16, the device further comprising:

a support brassiere comprising a cup for cupping the breast so that the breast is partially immobilized when the cup is positioned proximate the breast.

19. The system of claim 18, wherein the customized, contoured, upper-body immobilization device comprises substantially hardened two-part foam comprising an aperture sized to substantially mirror a shape of the cup.