Objective To investigate the advantages of shaping pad combined with thermoplastic membrane in postural fixation for radiotherapy patients of head and neck neoplasms.

Methods The clinical data of 50 patients with head and neck neoplasms treated by radiotherapy the First Hospital of Shanxi Medical University from February 2021 to December 2021 were collected, including 40 males and 10 females, aged (58.0±8.2) years. The selected patients were divided into the control group (20 cases) and the observation group (30 cases). The observation group was immobilized using individualized shaping pad with thermoplastic membrane, and the control group was fixed with standard plastics pillow with the thermoplastic membrane. The MV electronic portal imaging device (EPID) was carried out for postioning verification once a week, and the setup errors were compared in a vertical (abdominal and dorsal), longitudinal (head and foot), and lateral (left and right) direction. The setup errors were analyzed by independent sample t-test.

Results A total of 50 patients completed 258 EPID validations, including 101 validations in the observation group and 157 validations in the control group. With the target area as ROI, the setup errors in a vertical, longitudinal, and lateral direction of the observation group were lower than those of the control group ((0.057±1.805) mm vs. (0.599±2.531) mm, (0.569±1.611) mm vs. (0.637±2.239) mm; (0.020±2.946) mm vs. (0.780±1.957) mm, respectively), and the differences were statistically significant in a vertical and lateral direction (t=−2.435, P=0.016; t=2.289, P=0.023). With the head center as ROI, the setup errors in a vertical, longitudinal, and lateral direction of the observation group were lower than those of the control group ((−0.327±1.898) mm vs. (0.975±1.950) mm, (0.594±2.089) mm vs. (0.917±2.245) mm, (0.891±1.944) mm vs. (1.070±1.912) mm, respectively), and the difference was statistically significant in a vertical direction (t=5.320, P<0.001). With the neck center as ROI, the setup errors in a vertical, longitudinal, and lateral direction of the observation group were lower than those of the control group ((0.010±2.278) mm vs. (1.217±2.663) mm, (0.554±2.095) mm vs. (0.637±2.397) mm, (−0.574±2.321) vs. (−0.764±2.600) mm, respectively). Furthermore, and the differences were statistically significant in a vertical and lateral direction (t=−3.947, P<0.001; t=3.431, P=0.001).

Conclusions The application of shaping pad and thermoplastic membrane in postural fixation of head and neck neoplasms during radiotherapy can improve positioning accuracy and patients' comfort, indicating their clinical promotion value.