Anaesthesia for paediatric radiotherapy: A narrative review

Area of Science:

• Pediatric Oncology
• Radiation Oncology
• Anesthesiology

Background:

• Radiotherapy is a common cancer treatment for children, involving daily outpatient sessions over several weeks.
• The procedure requires patient cooperation and immobility, often necessitating sedation or anesthesia for younger patients.

Purpose of the Study:

• To review current literature on anesthesia and sedation practices in pediatric radiotherapy.
• To identify trends and challenges in managing anesthesia for pediatric cancer patients undergoing radiotherapy.

Main Methods:

• A literature search was conducted using keywords such as 'radiotherapy,' 'proton beam,' 'photon,' 'sedation,' 'anesthesia,' and 'pediatric.'
• Abstracts were assessed for relevance, and reference lists were reviewed for additional pertinent studies.

Main Results:

• Anesthesia is primarily required for younger children undergoing daily radiotherapy sessions.
• Common anesthetic techniques include general anesthesia with a supraglottic airway or deep sedation maintaining spontaneous ventilation.
• Propofol infusion is increasingly favored for sedation, though evidence for a standardized approach is limited.

Conclusions:

• Anesthesia for pediatric radiotherapy is typically limited to younger children.
• Patients undergoing radiotherapy may have complex health issues due to cancer and other treatments, requiring a multidisciplinary approach.
• Ensuring systems for escalating care during emergencies is crucial due to potential patient instability and treatment-related challenges.