OPEN: optimising patient experience in head and neck radiotherapy, a phase 3 randomised control trial comparing open versus closed face masks.
Jill Nicholson, Samantha Ryan, Ciaran Malone et al.
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In 30 seconds
This phase 3 randomised trial compared three immobilisation approaches in non-claustrophobic patients receiving radical head and neck radiotherapy: a closed 5-point mask without surface-guided radiotherapy (SGRT), and SGRT-supported open 3-point or 5-point masks. Among 230 randomised patients, inter-fraction motion differed significantly only along the longitudinal axis, with larger shifts in the closed-mask group than in either open-mask group (P < 0.001); no significant differences were found in other axes. At treatment completion, both open-mask groups reported more favourable tolerability, overall experience and distress measures than the closed-mask group (p < 0.01).
Key findings
- Longitudinal inter-fraction shifts were larger with the closed mask than with either open-mask approach (P < 0.001).
- No significant between-group differences were observed in vertical, lateral or rotational setup axes.
- At treatment completion, tolerability, overall experience and distress were more favourable in both open-mask groups than with the closed mask (p < 0.01).
Why it matters
Head and neck radiotherapy immobilisation can be distressing, while accurate positioning is essential. In this randomised comparison, SGRT-supported open masks were associated with better patient-reported experience and no reported disadvantage in setup accuracy across most measured axes. These findings inform evaluation of patient-centred immobilisation options, while applying specifically to the population and systems studied.
What to keep in mind
The trial included non-claustrophobic patients receiving radical radiotherapy; the abstract does not report longer-term outcomes or detailed patient-reported effect sizes.