Pediatric radiotherapy preparation: a scoping review.

Area of Science:

• Oncology
• Pediatric Medicine
• Radiotherapy

Background:

• Pediatric radiotherapy (RT) poses challenges for young patients needing to remain still, often leading to general anesthesia (GA) or sedation.
• GA/sedation carries risks including respiratory and neurocognitive side effects, increased costs, and resource strain.
• Preparation strategies aim to reduce GA reliance by improving patient understanding, cooperation, and comfort.

Purpose of the Study:

• To conduct a scoping review of pediatric RT preparation strategies.
• To identify service gaps and evaluate the effectiveness of existing approaches.
• To explore opportunities for improving pediatric RT preparation.

Main Methods:

• Scoping review of literature from 2000-2023.
• Databases searched: PubMed, Embase, Scopus, ScienceDirect.
• Included studies detailing preparation services; data extraction focused on interventions, outcomes, and gaps.

Main Results:

• 73 of 593 papers met inclusion criteria; 24% noted patient/carer challenges like anxiety.
• 46% of pediatric patients (<21 years) require GA/sedation for RT (60% for <3 years, 37% for >3 years).
• Emerging strategies (VR, play therapy) show promise, but gaps in multidisciplinary collaboration and specialized facilities exist.

Conclusions:

• Enhanced preparatory strategies are urgently needed for pediatric RT.
• Pre-treatment support, gamification, advanced technologies, and specialized facilities can improve experiences.
• These improvements may decrease dependence on GA/sedation for pediatric radiation therapy.