A Prospective Evaluation of Open Face Masks for Head and Neck Radiotherapy

Publication date: Available online 13 February 2016
Source:Practical Radiation Oncology
Author(s): David Wiant, Sarah Squire, Han Liu, Jacqueline Maurer, T. Lane Hayes, Benjamin Sintay
PurposeHead and neck radiotherapy patients (HN) are typically immobilized with closed thermoplastic masks that cover the face and may cause discomfort for patients. In this work we examine the use of open-masks for HN radiotherapy.Methods and MaterialsFifty HN patients were prospectively randomized into two groups (25 closed-masks, 25 open-masks). The open-mask group was monitored with surface imaging to evaluate intra-fraction motion. Both groups underwent daily volumetric imaging. All daily images were rigidly registered to their respective planning images to evaluate spinal canal and mandible position as a check for inter-fraction posture change. Posture changes were determined by the amount the spinal canal and mandible contours from the planning images had to be expanded to cover the structures on each daily image set. The vector length (VL) of the intra-fraction linear translations, spine, and mandible positions for each open-mask patient were checked for correlation with fraction number using Pearson's r value. All patients were given a weekly survey ranking anxiety and claustrophobia from 0 to 10 (0 = no issue, 10 = extreme issue).ResultsThe mean VL for all open-mask patients was 0.9 mm +/- 0.5 mm (1 SD). Only 1 patient showed significant correlation between VL and fraction number. The mean contour expansions to cover the spine and mandible were 1.5 mm +/- 0.9 mm and 1.8 mm +/- 1.3 mm for the closed-mask group, and 1.6 mm +/- 0.8 mm and 1.8 mm +/- 1.1 mm for the open-mask group. Both groups showed similar behavior relative to fraction number. The mean anxiety and claustrophobia scores were 1.63 and 1.44 for the closed-mask group, and 0.81 and 0.63 for the open-mask group. The groups were not significantly different.ConclusionsOpen-masks provide comparable immobilization and posture preservation to closed-masks for HN radiotherapy.



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