Radiation Therapy Without Anesthesia for a 2-Year-Old Child Using Audio-Visual Assisted Therapeutic Ambience in...

Area of Science:

• Pediatric Oncology
• Radiation Oncology
• Medical Technology

Background:

• Radiation therapy (RT) for pediatric cancers can cause significant anxiety and requires general anesthesia (GA) in young children.
• General anesthesia is resource-intensive, costly, and carries potential toxicities.
• Current technology, Audio-Visual Assisted Therapeutic Ambience in Radiation Therapy (AVATAR), is limited to children aged 3-10 years.

Observation:

• A 2-year-old with stage IV Wilms tumor underwent simulation and radiation therapy for bilateral whole-lung and left-flank irradiation.
• The patient's anxiety was assessed using the Modified Yale Preoperative Anxiety Score (mYPAS).
• AVATAR was used to deliver RT without sedation.

Findings:

• The patient experienced significant anxiety (mYPAS=14) during simulation without AVATAR.
• AVATAR use during RT resulted in significantly reduced anxiety (mYPAS=5, then 4) without GA.
• RT delivery time decreased by 66% (from 90 to 30 minutes) without GA.

Implications:

• AVATAR may be a feasible alternative to GA in younger pediatric patients (under 3 years) for radiation therapy.
• This approach can potentially reduce patient stress, anxiety, treatment costs, and appointment duration.
• Further studies are needed to validate AVATAR's efficacy in patients younger than 3 years.