Carbon fibre versus foam headrests in head and neck cancer radiotherapy: a retrospective evaluation

Introduction: This retrospective study addressed a literature gap by comparing set-up accuracy, dosimetric impact and user perception of carbon fibre versus foam headrests for head and neck cancer radiotherapy. Methods: One thousand image datasets from 50 patients were analysed, comparing carbon fibre (group one) and foam headrests (group two). Errors were recorded across five degrees of freedom. Evaluations included staff questionnaires on usability and Varian Eclipse dosimetric assessments for attenuation and conformity. Results: No significant differences in population systematic errors were observed. Carbon fibre showed a 0.23° reduction in pitch error, while foam showed a significant 0.1° reduction in yaw random error ( p = 0.028). Dosimetrically, carbon fibre demonstrated superior conformity and less attenuation. While 70% of radiographers preferred carbon fibre for stability, 100% rated foam more comfortable. Conclusion: Both headrests provide equivalent set-up accuracy. Selection should prioritise patient comfort and specific dosimetric requirements where clinical results are equivocal.