Evaluation of a novel head and neck immobilization device for external beam radiation therapy

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Date
2012-11-26
Authors
Willcock, Michael
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Abstract
The purpose of this study was to compare the novel CDR Systems MayoMold to the Civco Medical Solutions standard neck roll in order to determine if the MayoMold should become widely used for head and neck cancer radiation therapy immobilization at CancerCare Manitoba. Fifteen patients were enrolled in the standard neck roll cohort and ten patients were enrolled in the MayoMold cohort. Bony landmarks of clinical interest were selected and daily imaging was used to quantify daily changes in patient set up and deformations with respect to the digitally reconstructed radiograph created from each patient’s planning CT. Bayesian statistics were employed with support from Epidemiology at CancerCare Manitoba in order to compare the patients to themselves across all of their treatment fractions, to different patients in the same cohort, and to the other cohort. Subjective end points concerning the MayoMold were solicited from patients and staff. Several measures of patient immobilization, especially concerning the mandible, were found to be inferior in the MayoMold cohort. These results were statistically significant but not clinically significant, allowing the conclusion to be made that the MayoMold was not superior to the standard neck roll with regards to patient immobilization. Adverse subjective feedback and the increased cost of using the MayoMold skewed the subjective end points towards the negative. In all, it was not recommended that CancerCare Manitoba adopt the MayoMold.
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Medicine
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