title: Randomized trial on two types of thermoplastic masks for patient immobilization during radiation therapy for head-and-neck cancer.
abstract: OBJECTIVE
  Radiation therapy for head-and-neck cancer requires a reliable immobilization for an accurate and consistent treatment setup. This prospective, randomized study was done to compare two types of Posicast thermoplastic face masks, in terms of reproducibility, patient comfort, tolerability, and skin damage.
  
  
  METHODS
  The patients were randomly assigned to use a head mask (HM) or a head-and-shoulder mask (HSM). Three-dimensional treatment planning was followed by fractionated external-beam radiation therapy. Reproducibility was assessed by comparing port films with simulator films twice during treatment and by comparing actual treatment table positions weekly. Patient tolerability and comfort were studied weekly. The radiation-induced skin damage was assessed every week according to the World Health Organization toxicity scale.
  
  
  RESULTS
  A total of 260 patients were included, and 241 (93%) were evaluated. There were no statistically significant differences between the groups (HM or HSM) in terms of reproducibility. Patients using HSM experienced significantly more claustrophobia (p = 0.023). Patients allocated to HSM receiving > or = 60 Gy were found to have more skin reactions.
  
  
  CONCLUSIONS
  The smaller HM reduced feelings of claustrophobia, as well as skin reactions, for patients receiving > or = 60 Gy. The smaller mask did not compromise the reproducibility of the setup.
authors.affiliation: Department of Oncology, Karolinska University Hospital, Huddinge, Stockholm, Sweden. lena.sharp@kus.se
authors.forename: Lena
authors.initials: L
authors.lastname: Sharp
authors.forename: Freddi
authors.initials: F
authors.lastname: Lewin
authors.forename: Hemming
authors.initials: H
authors.lastname: Johansson
authors.forename: David
authors.initials: D
authors.lastname: Payne
authors.forename: Ansi
authors.initials: A
authors.lastname: Gerhardsson
authors.forename: Lars Erik
authors.initials: LE
authors.lastname: Rutqvist
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004867:Equipment Design; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D007103:Immobilization / Q000379:methods*; D008297:Male; D008397:Masks; D008875:Middle Aged; D011446:Prospective Studies; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods; D015203:Reproducibility of Results