A psychoeducational intervention reduces the need for anesthesia during radiotherapy for young childhood cancer patients

Sonja Haeberli¹ , Michael A Grotzer¹ , Felix K Niggli¹ , Markus A Landolt² , Claudia Linsenmeier³ , Roland A Ammann⁴ and Nicole Bodmer¹

¹University Children's Hospital of Zurich, Department of Oncology, Steinwiesstr. 75, 8032 Zurich, Switzerland

²University Children's Hospital of Zurich, Department of Psychosomatics and Psychiatry, Steinwiesstrasse 75, Zurich, Switzerland

³University Hospital Zurich, Department of Radio-Oncology, Raemistr. 100, 8032 Zurich, Switzerland

⁴University Children's Hospital of Berne, Division of Pediatric Hematology-Oncology, Inselspital, 3010 Berne, Switzerland

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Radiation Oncology 2008, 3:17doi:10.1186/1748-717X-3-17


Published:	4 June 2008

Abstract

Background

Radiotherapy (RT) has become an important treatment modality in pediatric oncology, but its delivery to young children with cancer is challenging and general anesthesia is often needed.

Methods

To evaluate whether a psychoeducational intervention might reduce the need for anesthesia, 223 consecutive pediatric cancer patients receiving 4141 RT fractions during 244 RT courses between February 1989 and January 2006 were studied. Whereas in 154 RT courses corresponding with 2580 RT fractions patients received no psychoeducational intervention (group A), 90 RT courses respectively 1561 RT fractions were accomplished by using psychoeducational intervention (group B). This tailored psychoeducational intervention in group B included a play program and interactive support by a trained nurse according to age to get familiar with staff, equipment and procedure of radiotherapy.

Results

Group A did not differ significantly from group B in age at RT, gender, diagnosis, localization of RT and positioning during RT. Whereas 33 (21.4%) patients in group A got anesthesia, only 8 (8.9%) patients in group B needed anesthesia. The median age of cooperating patients without anesthesia decreased from 3.2 to 2.7 years. In both uni- and multivariate analyses the psychoeducational intervention significantly and independently reduced the need for anesthesia.

Conclusion

We conclude that a specifically tailored psychoeducational intervention is able to reduce the need for anesthesia in children undergoing RT for cancer. This results in lower costs and increased cooperation during RT.