Head and neck treatments

For Head & Neck radiation therapies, a patient’s position needs to be reproduced accurately, in order to ensure effective treatments and minimize side effects. Historically, full-face masks were used to accomplish this.

But the sub-millimetric accuracy offered by SGRT with AlignRT has enabled clinics to implement open-face masks – or even to move towards completely maskless treatments.

AlignRT can reduce the complexity of treatment setups and can track motion with better than 1mm accuracy, with reduced need for immobilization. AlignRT is fully integrated into the treatment workflow, allowing for automatic beam pause if the patient moves during treatment delivery.

The benefits of AlignRT® for H&N

AlignRT provides patient-centered care for Head and Neck treatments.

Studies have shown that patients have reported mask immobilizations, using closed-face masks, to be among the “worst” parts of their Radiation Therapy experiences¹. Nearly half (43%) of patients reported clinically significant anxiety before their mask-making session². 24% of patients were also reported to have some level of session disruption during their first treatment³. Improving patient comfort while minimizing session disruption are key elements in improving treatment outcomes.

The accuracy of AlignRT enables it to reduce the need for patient immobilizations, resulting in a superior patient experience, while still maintaining and improving the accuracy of setups⁴. AlignRT, combined with the Postural Video module shows the outline of body parts to help ensure head, shoulders and neck are all positioned correctly, and has been shown in a study to reduce time per fraction by 90 seconds⁵.

AlignRT also has the potential to better evaluate changes in skin contour due to weight loss earlier than other methods.

43%

*Percentage of patients reporting “significant anxiety” before mask-making sessions²

Find a list of compatible open-face masks here.

The benefits of MapRT® for H&N

Non-coplanar treatment planning using clearance mapping has shown the potential to enhance outcomes, as shown in this planning study of head and neck retreatments: MapRT has been shown to facilitate noncoplanar planning by showing which couch/gantry angles are safe for delivery.

Calculated Outcome Probabilities

“4Pi plans may allow dose escalation with significant and consistent improvements in critical organ sparing, tumor control, and coverage.” ²

Voice of experience

“We use thermoplastic open masks with head and shoulder support, this helps ensure reproducible positioning, we use multiple ROI’s to position the patient and CBCT comparisons has shown accurate positioning and excellent correlation with internal imaging.”

Kirsten Hierholz, Chief Medical Physicist
Klinikum Darmstadt, Institut für Radioonkologie und Strahlentherapie, Germany

“There are a number of publications now on minimal immobilization in head and neck treatments: clinical research is finding that it’s actually better in many cases to drastically minimize the extent of immobilization, not only for patient comfort but also for patient stability. AlignRT offers the advantage of open-face masks combined with directly tracking the patient surface, allowing for highly accurate treatments whilst minimizing the level of immobilization.”

Daniel Bailey, PhD
Head of Physics, Sarah Cannon, Atlanta, GA, USA

“I will be forever grateful for the radiation therapy team that saved my life with precisely targeted treatment. Ten years after treatment for stage four HPV-related oropharyngeal cancer, I can speak, swallow and live a normal life. However, my 33 days in the full-face Mask was the most traumatic experience of my life. New styles of open-faced mask and better education before the patient’s first treatment will improve the patient’s experience and psychological recovery. Thank you for this innovation!”

Julie McCrossin
Head & neck cancer survivor and patient advocate

Selected published evidence

“Has been shown to detect rigid setup errors with good accuracy.”²

Olga Gopan and Qiuwen Wu
Evaluation of the accuracy of a 3D surface imaging system for patient setup in head and neck cancer radiotherapy

“Open-face mask improves comfort and tolerability for patients”³

TBC

“Comparable immobilization and posture preservation to closed masks”⁴

David Wiant, Sarah Squire, Han Liu, Jacqueline Maurer, T Lane Hayes, Benjamin Sintay
A prospective evaluation of open face masks for head and neck radiation therapy

"Patients reported greater neck and shoulder comfort and overall satisfaction during CT simulation…Open masks with CHR provide comparable yet comfortable immobilization to closed masks with SHR, for HN radiotherapy.”⁵

Zaheeda Mulla
A comparative study between open-face and closed-face masks for head and neck cancer (HNC) in radiation therapy

“In head and neck cancer cases, postural reproducibility deteriorates due to the non-rigidity of H&N…image-guided corrections cannot completely compensate for this.”⁶

Find a list of compatible open-face masks here.

SGRT Community H&N presentations

For more peer presentations, visit the SGRT Community website.

Get in touch

Vision RT’s family of SGRT solutions guide radiation therapy for better patient care at every step: sim, planning and treatment.

Whether you’re looking for a quote, a product demo (virtual or in-person) or just more information, please get in touch:

References

Olausson, K., Holst Hansson, A., Zackrisson, B., Edvardsson, D., Östlund, U. and Nyholm, T. (2017). Development and psychometric testing of an instrument to measure the patient’s experience of external radiotherapy: The Radiotherapy Experience Questionnaire (RTEQ). Technical Innovations & Patient Support in Radiation Oncology, 3-4, pp.7–12. doi:https://doi.org/10.1016/j.tipsro.2017.06.003.
Burns, M., Campbell, R., French, S., Dhillon, H.M., Butow, P.N., Pritchard, A. and Sundaresan, P. (2022). Trajectory of anxiety related to radiation therapy mask immobilization and treatment delivery in head and neck cancer and radiation therapists’ ability to detect this anxiety. ‘Anxiety during radiation therapy with mask’. Advances in Radiation Oncology, p.100967. doi:https://doi.org/10.1016/j.adro.2022.100967.
Clover, K., Oultram, S., Adams, C., Cross, L., Findlay, N. and Ponman, L. (2010). Disruption to radiation therapy sessions due to anxiety among patients receiving radiation therapy to the head and neck area can be predicted using patient self-report measures. Psycho-Oncology, 20(12), pp.1334–1341. doi:https://doi.org/10.1002/pon.1854.
Wei, W., Ioannides, P.J., Sehgal, V. and Daroui, P. (2020). Quantifying the impact of optical surface guidance in the treatment of cancers of the head and neck. Journal of Applied Clinical Medical Physics, 21(6), pp.73–82. doi:https://doi.org/10.1002/acm2.12867.
“Large Network Approach: Streamlining Workflows & Increasing Efficiency” Kira-Lee Oliver, Director – Service of the Future GenesisCare, 2022 SGRT USA Meeting