Paediatric radiation therapy without anaesthesia - Are the children moving?
Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved..
PURPOSE: Children who require radiation therapy (RT) should ideally be treated awake, without anaesthesia, if possible. Audiovisual distraction is a known method to facilitate awake treatment, but its effectiveness at keeping children from moving during treatment is not known. The aim of this study was to evaluate intrafraction movement of children receiving RT while awake.
METHODS: In this prospective study, we measured the intrafraction movement of children undergoing treatment with fractionated RT, using pre- and post-RT cone beam CT (CBCT) with image matching on bony anatomy. Study CBCTs were acquired at first fraction, weekly during RT, and at last fraction. The primary endpoint was the magnitude of vector change between the pre- and post-RT scans. Our hypothesis was that 90 % of CBCT acquisitions would have minimal movement, defined as <3 mm for head-and-neck (HN) treatments and <5 mm for non-HN treatments.
RESULTS: A total of 65 children were enrolled and had evaluable data across 302 treatments with CBCT acquisitions. Median age was 11 years (range, 2-18; 1st and 3rd quartiles 7 and 14 years, respectively). Minimal movement was observed in 99.4 % of HN treatments and 97.2 % of non-HN treatments. The study hypothesis of >90 % of evaluations having minimal movement was met. Children who were age >11 years moved less at initial evaluation but tended to move more as a course of radiation progressed, as compared to children who were younger.
CONCLUSION: Children receiving RT with audiovisual distraction while awake had small magnitudes of observed intrafraction movement, with minimal movement in >97 % of observed RT fractions. This study validates methods of anaesthesia avoidance using audiovisual distraction for selected children.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:193 |
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| Enthalten in: |
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology - 193(2024) vom: 15. März, Seite 110120 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ritchie, Tatiana [VerfasserIn] |
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| Links: |
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| Themen: |
Child |
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| Anmerkungen: |
Date Completed 18.03.2024 Date Revised 18.03.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.radonc.2024.110120 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM368005259 |
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| 100 | 1 | |a Ritchie, Tatiana |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Paediatric radiation therapy without anaesthesia - Are the children moving? |
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| 500 | |a Date Revised 18.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved. | ||
| 520 | |a PURPOSE: Children who require radiation therapy (RT) should ideally be treated awake, without anaesthesia, if possible. Audiovisual distraction is a known method to facilitate awake treatment, but its effectiveness at keeping children from moving during treatment is not known. The aim of this study was to evaluate intrafraction movement of children receiving RT while awake | ||
| 520 | |a METHODS: In this prospective study, we measured the intrafraction movement of children undergoing treatment with fractionated RT, using pre- and post-RT cone beam CT (CBCT) with image matching on bony anatomy. Study CBCTs were acquired at first fraction, weekly during RT, and at last fraction. The primary endpoint was the magnitude of vector change between the pre- and post-RT scans. Our hypothesis was that 90 % of CBCT acquisitions would have minimal movement, defined as <3 mm for head-and-neck (HN) treatments and <5 mm for non-HN treatments | ||
| 520 | |a RESULTS: A total of 65 children were enrolled and had evaluable data across 302 treatments with CBCT acquisitions. Median age was 11 years (range, 2-18; 1st and 3rd quartiles 7 and 14 years, respectively). Minimal movement was observed in 99.4 % of HN treatments and 97.2 % of non-HN treatments. The study hypothesis of >90 % of evaluations having minimal movement was met. Children who were age >11 years moved less at initial evaluation but tended to move more as a course of radiation progressed, as compared to children who were younger | ||
| 520 | |a CONCLUSION: Children receiving RT with audiovisual distraction while awake had small magnitudes of observed intrafraction movement, with minimal movement in >97 % of observed RT fractions. This study validates methods of anaesthesia avoidance using audiovisual distraction for selected children | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Child | |
| 650 | 4 | |a Child, Preschool | |
| 650 | 4 | |a Cone-Beam CT | |
| 650 | 4 | |a Radiotherapy Setup Errors | |
| 650 | 4 | |a Radiotherapy Target Organ Alignment | |
| 650 | 4 | |a Radiotherapy, Image-Guided | |
| 700 | 1 | |a Awrey, Susan |e verfasserin |4 aut | |
| 700 | 1 | |a Maganti, Manjula |e verfasserin |4 aut | |
| 700 | 1 | |a Chahin, Rehab |e verfasserin |4 aut | |
| 700 | 1 | |a Velec, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Hodgson, David C |e verfasserin |4 aut | |
| 700 | 1 | |a Dama, Hitesh |e verfasserin |4 aut | |
| 700 | 1 | |a Ahmed, Sameera |e verfasserin |4 aut | |
| 700 | 1 | |a Winter, Jeff D |e verfasserin |4 aut | |
| 700 | 1 | |a Laperriere, Normand |e verfasserin |4 aut | |
| 700 | 1 | |a Tsang, Derek S |e verfasserin |4 aut | |
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