Supine Craniospinal Irradiation Setup with Two Spine Fields

Craniospinal irradiation is an integral part of treatment for a number of cancers. Typically, patients are positioned prone, which allows visualization of field matches. However, a supine position allows better airway access for patients requiring anesthesia, and is more comfortable for patients. One potential difficulty with supine positioning occurs when the patient is tall and requires matching 2 spine fields. We describe a technique to match the spine fields using light fields on the bottom of the treatment table, and verified the approach on a phantom. The accuracy of the technique is demonstrated for the first 4 patients, with the majority of field gaps and overlaps below our clinical tolerance of 2 mm.