{"entity":{"id":"paper-open-trial-open-face-masks-sgrt-radiother-oncol-2026","kind":"paper","name":"OPEN: optimising patient experience in head and neck radiotherapy, a phase 3 randomised control trial comparing open versus closed face masks","aka":[],"tldr":"People having radiotherapy for head and neck cancer were randomly given the standard closed face mask or one of two open masks, with cameras tracking the face during treatment. The open masks were set up as accurately and were significantly better tolerated.","summary":"The OPEN trial randomised 230 non-claustrophobic patients having radical head and neck radiotherapy between January 2024 and May 2025, one to one to one, to a standard closed five-point mask without surface guidance, or to an open three-point or open five-point mask with surface-guided radiotherapy. Set-up accuracy was measured with daily cone-beam CT and surface guidance. Inter-fraction shifts differed only in the longitudinal axis, where the closed-mask group had larger shifts than both open-mask groups (P < 0.001); no other axis differed. At the end of treatment, tolerability, overall experience and distress were significantly more favourable in both open-mask groups (p < 0.01). An earlier interim analysis of 56 patients found intrafraction motion within margins of 1.8, 1.7 and 1.3 mm for all mask types.","asOf":"2026-10-20","links":[{"label":"Radiotherapy and Oncology 2026","url":"https://doi.org/10.1016/j.radonc.2026.111779"},{"label":"PubMed 42731759","url":"https://pubmed.ncbi.nlm.nih.gov/42731759/"},{"label":"OPEN interim analysis of intrafraction motion (Radiotherapy and Oncology 2025)","url":"https://doi.org/10.1016/j.radonc.2025.110941"}],"tags":["precision","radiation"],"related":[],"cancers":["head-and-neck"],"sections":["radiation"],"technologies":["surface-guided-radiotherapy","patient-positioning-surface-guidance-systems"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["radiotherapy-and-oncology"],"dependsOn":[],"notes":[],"journal":"Radiotherapy and Oncology","year":2026,"doi":"10.1016/j.radonc.2026.111779","pmid":"42731759","authors":"Nicholson J, Ryan S, Malone C, et al.","paperType":"rct","findings":["230 patients randomised to a closed mask without surface guidance or one of two open masks with it.","Set-up accuracy equivalent; the only difference was larger longitudinal shifts with the closed mask (P < 0.001).","Tolerability, overall experience and distress significantly better with both open masks (p < 0.01)."],"whatItMeans":"Surface guidance allowed the face mask to be opened without losing set-up accuracy, and patients tolerated the open masks better. It is a gain in patient experience made possible by precision, rather than a gain in cancer control.","caveats":["Claustrophobic patients were excluded, so the people who would gain most were not studied.","Cancer control and late side effects are not reported in the abstract."],"participants":230},"route":"/key-papers/paper-open-trial-open-face-masks-sgrt-radiother-oncol-2026/","neighbours":{"cancer":[{"id":"head-and-neck","kind":"cancer","name":"Head and neck squamous cell carcinoma","route":"/cancers/head-and-neck/"}],"section":[{"id":"radiation","kind":"section","name":"Radiation Therapy","route":"/fronts/radiation/"}],"technology":[{"id":"patient-positioning-surface-guidance-systems","kind":"technology","name":"Patient positioning and surface guidance systems (AlignRT, Catalyst, ExacTrac Dynamic)","route":"/technologies/patient-positioning-surface-guidance-systems/"},{"id":"surface-guided-radiotherapy","kind":"technology","name":"Surface-guided radiotherapy (SGRT)","route":"/technologies/surface-guided-radiotherapy/"}],"journal":[{"id":"radiotherapy-and-oncology","kind":"journal","name":"Radiotherapy and Oncology","route":"/journals/radiotherapy-and-oncology/"}]}}