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Preparation of pediatric patients for treatment with proton beam therapy
Masashi Mizumoto1, Yoshiko Oshiro1, Kaoru Ayuzawa2
1Department of Radiation Oncology, Tsukuba University, Ibaraki, Japan.
Insights
Preparing pediatric patients for proton beam therapy (PBT) significantly reduces treatment time for those who can communicate. This strategy enhances PBT efficiency in pediatric oncology.
Area of Science:
- Pediatric oncology
- Radiation therapy
- Medical physics
Background:
- Anesthesia is frequently required for pediatric patients undergoing proton beam therapy (PBT), potentially increasing treatment duration.
- Optimizing PBT protocols for pediatric patients is crucial for improving patient experience and resource utilization.
Purpose of the Study:
- To evaluate a preparatory program designed to facilitate smooth PBT administration in pediatric patients.
- To determine if patient preparation can reduce PBT treatment times in children.
Main Methods:
- A 10-day preparation protocol was implemented, including facility familiarization, gradual acclimatization to the treatment bed, and use of engaging stimuli.
- Pediatric patients (n=111) were categorized into three groups based on their ability to follow instructions and communicate.
- The preparatory program was administered to patients who could communicate but struggled with prolonged solitary stays (Group B).
Main Results:
- Patients in Group B, who received preparation, showed a significant reduction in PBT treatment time (p=0.003).
- Mean treatment times for Group B decreased from 17.1 minutes (days 2-6) to 13.0 minutes (last 5 days).
- Patients who could follow instructions well (Group A) had the shortest treatment times, while those unable to follow instructions (Group C) had longer durations.
Conclusions:
- A structured preparation program is effective for pediatric patients capable of communication undergoing PBT.
- This approach leads to more efficient PBT delivery, reducing overall treatment time and potentially minimizing the need for anesthesia.
Purpose:
Anesthesia is often used in proton beam therapy (PBT) for pediatric patients and this may prolong the treatment time. The aim of the study was to examine preparation of pediatric patients to allow smooth performance of PBT.
Material And Methods:
Preparation was initiated 1-2days before treatment planning CT and continued for 10days. The patient first visited the facility to become familiar with the treatment room and staff. As the second step, the patient stayed in the treatment bed for a certain time with their mother, and then stayed on the treatment bed alone. Special fixtures painted with characters, music, and gifts were also prepared.
Results:
From 2010 to 2014, 111 pediatric patients underwent PBT. These patients were divided into 3 groups: 40 who could follow instructions well (group A, median age: 13.6years old), 60 who could communicate, but found it difficult to stay alone for a long time (group B, median age: 4.6years old), and 11 who could not follow instructions (group C, median age: 1.6years old). Preparation was used for patients in group B. The mean treatment times in groups A, B and C were 13.6, 17.1, and 15.6min, respectively, on PBT treatment days 2-6, and 11.8, 13.0, and 16.9min, respectively, for the last 5days of PBT treatment. The time reduction was significant in group B (p=0.003).
Conclusion:
Preparation is useful for pediatric patients who can communicate. This approach allows PBT to be conducted more smoothly over a shorter treatment time.
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