What techniques do you use to treat patients who weigh more than the treatment table limit?

In our institutional experience, this weighty question arises more often than we would prefer and most commonly for cervical cancer patients.

If the patient is only nominally beyond the limit, it is important to consider that the weight limits are consequent to the tolerance parameters of the motors rather than of the weight-bearing capacity of the table proper. You may be willing to risk this. Or perhaps not.

If the capacity of the table is substantially exceeded, we treat the patient on a modified stretcher, as described and pictured in an article from our institution (Whitley, et al., PRO 2012; PMID 24674172). Our arrangement of plywood, styrofoam, and carbon fiber tabletop creates a cavity below the patient's pelvis that can accommodate...

I've had more of this experience in endometrial, rather than cervical CA patients.... usually we try to get them to lose weight, sometimes will refer them out, as I believe some of the newer linacs and CTs can accomodate a higher weight limit than older machines