Open-Face Masks in Radiotherapy: Enhancing Therapeutic Strategies for Head and Neck and Brain Cancer Patients—A Comprehensive Scoping Review

Simple Summary Conventional closed face masks (CFMs) are used in radiotherapy for head and neck cancer (HNC) and brain cancer (BC) but can cause discomfort and anxiety, affecting the patient experience. Recently, open-face masks (OFMs) have been introduced as an alternative. This study reviews and explores the application and use of OFMs in the treatment of HNC and BC, analyzing 19 relevant studies. The analysis shows heterogeneity in the type of OFMs used, especially in BC. In some cases, they are used alone, while in others, they are combined with complementary devices such as mouth bites. For both treatment sites, the review shows that OFMs, especially in combination with surface-guided radiotherapy (SGRT), offer significant advantages in terms of patient comfort and positioning accuracy. The results suggest that OFMs can achieve sub-millimeter and sub-degree reproducibility, which supports their clinical integration.Abstract Introduction: The main goal of radiotherapy (RT) is to deliver a precise dose to the target while sparing the surrounding normal tissue and minimizing side effects. Appropriate patient immobilization is crucial, especially for head and neck cancer (HNC) and Brain Cancer (BC). Conventional closed-face masks (CFMs), while effective in minimizing head motion, can cause significant discomfort, anxiety, and claustrophobia. Open-face masks (OFMs) have been developed to increase patient comfort while providing precise immobilization. Methods: Following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) extension for scoping reviews and the Arskey and O'Malley framework, an electronic search of EMBASE, PubMed, SCOPUS, and Web of Science was conducted to identify original studies reporting the use and description of OFMs in clinical practice up to April 2024. The inclusion criteria were English-language articles focusing on OFMs for HNC and BC patients undergoing RT. Results: Of 618 titles, 19 articles fulfilled the selection criteria. Most studies were comparative (n = 13) or observational (n = 6). The articles were categorized by treatment site, resulting in three groups: BC (n = 14, 68.4%), HNC (n = 4, 21.4%), and mixed (n = 2, 10.5%), which includes both BC and HNC. Of note, 82.4% (n = 16) of the included studies were published from 2020 onwards, emphasizing the recent adoption of OFM in clinical practice. Conclusions: The reviewed studies show that OFMs, in combination with SGRT, offer significant advantages in terms of patient comfort and positioning accuracy in HNC and BC treatments. Reproducibility in the sub-millimeter and sub-degree range can be achieved, which supports the use of OFMs in clinical practice. Future research should explore innovative combinations of immobilization and monitoring to further improve RT outcomes and ensure precise treatment while increasing patient comfort.