A retrospective analysis comparing set up errors from standard versus customised headrests for head and neck...

Area of Science:

• Radiation Oncology
• Medical Physics
• Cancer Treatment

Background:

• The COVID-19 pandemic necessitated reducing hospital visits for cancer patients undergoing radiotherapy.
• Standard headrests were implemented at the Northern Centre for Cancer Care (NCCC) as an alternative to customized headrests to minimize patient contact.
• Standard headrests require one mould room appointment, contrasting with three appointments for customized headrests.

Purpose of the Study:

• To compare the setup reproducibility and immobilization accuracy between standard headrests (SHR) and customized headrests (CHR) in head and neck radiotherapy.
• To evaluate the clinical implications of using standard headrests in terms of patient positioning during radiotherapy treatments.

Main Methods:

• A retrospective analysis of 20 patients (10 SHR, 10 CHR) treated between December 2019 and June 2020.
• Review of 547 cone beam computed tomography images to assess chin, shoulder, and spine positioning accuracy.
• Statistical analysis using the chi-squared test to compare positional deviations between the two headrest groups.

Main Results:

• Customized headrests demonstrated significantly better reproducibility for shoulder (p<0.001) and spine (p<0.001) positioning compared to standard headrests.
• Chin positioning was also more accurate with customized headrests (p=0.046).
• The customized headrest group had no setup re-scans, while the standard headrest group required 10 re-scans.

Conclusions:

• While standard headrests reduce patient hospital visits, potentially lowering COVID-19 exposure, customized headrests provide superior immobilization and setup reproducibility in head and neck radiotherapy.
• The findings indicate that customized headrests are more reliable for patient positioning accuracy.