2283 - Impact of Anterior and Posterior Changes in Patient Hair during Radiotherapy on Precision Radiotherapy for Gliomas: A Real-World Study
Presenter(s)
F. T. Yang1, B. Fei2, L. Bo2, L. Zhang3, J. Li4, L. L. Xu5, J. Zang6, and L. N. Zhao6; 1Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University., xi'an, shaanxi, China, 2Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University. Xi’an, China, Xi'an, Shanxi, China, 3Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, xi'an, Shaanxi, China, 4Department of Radiation Oncology,Xijing Hospital,Air Force Medical University CN, Xi’an, China, 5Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, xi'an, shaanxi, China, 6Department of Radiation Oncology, Xijing Hospital, Air Force Medical University, Xi'an, China
Purpose/Objective(s): Radiotherapy is a crucial component in the comprehensive treatment of gliomas. However, damage to hair follicle cells during radiotherapy can lead to hair loss. Hair loss or haircuts during concurrent radiotherapy and radiochemotherapy may affect the therapist's ability to accurately position the patient, resulting in significant placement errors that can compromise treatment efficacy. This study aims to investigate the impact of severe hair loss or haircuts, particularly in the postoccipital region, on the precision of radiotherapy for gliomas, providing a reference for clinical practice.
Materials/Methods: This study employed a before-and-after controlled design using patient data. We retrospectively analyzed data from glioma patients who underwent precision radiotherapy between January 2022 and January 2025. Patients with severe haircuts or postoccipital alopecia (collectively referred to as alopecia) were included. Data on positioning errors before and after alopecia were collected. Cone beam CT (CBCT) was performed weekly and matched with planned CT to determine error values in three directions. SPSS 25.0 was used for statistical analysis of positioning errors and required target zone boundaries before and after alopecia.
Results: Of the 231 glioma patients treated with radiotherapy, 61 met the inclusion criteria (33 with haircuts and 27 with alopecia). The median age was 51 years (range: 19-78 years), with 33 men and 28 women. The dose range was 50-69 Gy, and the number of radiotherapy sessions ranged from 25 to 30. The median time for haircuts was 18 sessions (range: 15-23), and for alopecia, it was 20 sessions (range: 12-25). A total of 357 CBCT datasets (184 before alopecia and 173 after alopecia) from 61 patients were analyzed. Positioning errors in the X, Y, Z, and Rtn directions before and after alopecia were (1.02 ± 0.89) mm, (1.21 ± 0.86) mm, (1.16 ± 0.80) mm, (0.77 ± 0.81)° vs. (1.07 ± 0.87) mm, (1.49 ± 0.93) mm, (1.36 ± 0.76) mm, and (0.94 ± 0.81)°, respectively. The p-values were 0.574, 0.004, 0.013, and 0.049. The required PTV margins for the X, Y, and Z directions before and after alopecia were 2.57, 3.14, 3.01, and 2.69, 4.09, 3.65, respectively.
Conclusion: This real-world study demonstrates that hair loss (due to haircuts or severe alopecia) during radiotherapy can increase positioning errors and reduce positioning repeatability in glioma patients. It is recommended that clinicians closely monitor changes in patients' hair and promptly adjust radiotherapy plans for those experiencing haircuts or severe postoccipital alopecia to ensure treatment precision and efficacy.