A comparative study to evaluate the feasibilityand efficacy of use of mehendi vs temporary pen markings for skin marking in patients undergoing conventional external beam radiotherapy with Cobalt 60 machine
Keywords:Mehendi, skin markings, external beam radiotherapy
Introduction and Aim: The most common practice for marking the radiation field borders in conventional radiotherapy is with marker pens. In the hot and humid environment in India these markings rapidly fade and require remarking. In some cases, they require re-simulation and re-planning. Mehndi has been used in India for ceremonial marking on skin for long. Here we seek to evaluate the same for radiotherapy.
Materials and Methods: Eighty-two patients with no history of hyper-sensitivity to mehendi were scheduled to be analyzed on per protocol treatment basis, with 41 in each arm. Subjects were randomized by lottery method till the target number in one of the arms is reached. Since one subject in each arm had not received the per protocol management due to default, two more subjects were included and randomized. The minimum duration of treatment was 5 weeks. Markings were done either with mehndi cones (Arm A) or conventionally used Skin marking pens. They were repeated as per requirements. The number of application and gap between them were recorded. The data was later analyzed with SPSS v23 for frequencies, independent sample T test, including Mann-Whitney test. The analysis was per protocol.
Results: No incidence of hypersensitivity to mehendi occurred.The mean and median number of applications was significantly less in the Mehndi arm compared to control arm (median being 2 in mehndi arm compared to 4 in Pen arm). The median gap between applications and each application was also significantly lower in the Mehndi arm (11.5 days vs 7.25 days). There was no significant difference with visualization. The comfort level of the technologists, consultants and patients were better with Mehndi than with pen arm on Likert scale.
Conclusion: Mehndi is more durable than the pen marking it is equally visible for health care professionals and more comfortable to patients. The skin tone of our patients did not pose any challenge in visualization during set up either in ambient lighting or with lasers.
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