Complications in pediatric patients receiving anesthesia-assisted radiation therapy (AART) are rare, but the procedure is time-, space-, and resource-consuming. We analyzed our experience with AART for identifiable patterns regarding age and gender in children receiving daily proton radiation therapy.
Tara M. Hansen, MD, Kevin P. McMullen, MD, Jeffrey C. Buchsbaum, MD, PhD, Jennifer S. Bratton, RN, Peter A. Johnstone, MD, FACR; Indiana University School of Medicine
Objective: Complications in pediatric patients receiving anesthesia-assisted radiation therapy (AART) are rare, but the procedure is time-, space-, and resource-consuming. Influencing the decision to use AART may include ill-defined patient functional or psychological factors, as well as parent/physician discretion. We analyzed our experience with AART for identifiable patterns regarding age and gender in children receiving daily proton radiation therapy.
Materials and Methods: After institutional review board (IRB) approval, we reviewed our records from the Indiana University Health Proton Therapy Center for patients requiring AART between January 9, 2004 and June 30, 2013 with respect to age and gender in our pediatric patients (defined as patients ≤ 18 years of age).
Results: A total of 390 pediatric patients were treated in this era. Of them, 182 were girls and 208 were boys. The median age at start of treatment for pediatric patients treated with AART was 4 years vs 13 years for those not requiring AART. Similarly, the median age at start of treatment for pediatric boys and girls treated with AART compared with those not requiring AART was 4 years vs 13 years and 3 years vs 12 years, respectively. Overall, the likelihood of requiring AART by age is shown in the figure. All children ≤ 3 years of age and the majority of children ≤ 6 years of age required AART. There was no significant difference in any age group by gender.
Conclusion: While children aged ≤ 3 years invariably require AART in our experience, not surprisingly, the need for AART decreases with increasing age. A small cadre of older children has functional or other issues that require them to receive AART for daily radiation treatment. There is no difference in AART requirement by gender. This pattern of care data may assist centers in preplanning needs for pediatric radiation therapy cases referred from distant referral sites. Additionally, it establishes a baseline curve for AART requirements in the pediatric population upon which future studies can build.