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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.
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.
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.
Shares Radiotherapy and Oncology and the tags precision, radiation.
Shares Surface-guided radiotherapy (SGRT) and the tags precision, radiation.
Shares the tags precision, radiation.
Shares the tags precision, radiation.
Shares the tags precision, radiation.
Shares the tags precision, radiation.
Shares the tags precision, radiation.
Shares the tags precision, radiation.
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