Proton therapy for paediatric cancer patients is an effective treatment; however, young children have may have difficulties staying still during irradiation. This study investigated the indication of general anaesthesia in paediatric proton therapy. Background information and anaesthesia/treatment protocols were retrospectively extracted from the medical records of cancer patients under 15 years who underwent proton therapy at Southern TOHOKU General Hospital, Fukushima, Japan between April 2016 and December 2018. The anaesthesia and non-anaesthesia groups were compared to evaluate factors determining the need for general anaesthesia. Thirty-two patients who received 285 irradiations were analysed. The median age was 5 years old (range: 1–15), and 13 patients (40.6%) were female. Twelve (37.5%) patients received general anaesthesia. In the general anaesthesia group, airway management using a laryngeal mask was performed in 11 patients (91.6%). Patient age was significantly lower in the general anaesthesia group than in the non-anaesthetised group (p < 0.001). Considering all background factors, only age was strongly associated with anaesthesia in the univariate logistic regression model (odds ratio 0.55 [95% confidence interval 0.35–0.86]; P < 0.01). Thus, age is one of the most important factors determining the need for general anaesthesia during proton therapy in children.

Background: Proton therapy for pediatric cancer patients is effective treatments. Young children have difficulties staying still during irradiation, so general anesthesia is often required. This study investigated the indication for general anesthesia in pediatric proton therapy.Methods: We focused on cancer patients under 15 years old who underwent proton therapy at Southern TOHOKU General Hospital, Fukushima, Japan from April 2016 to December 2018. Background information and anesthesia/treatment protocols were retrospectively extracted from the electronic medical record. The anesthesia and non-anesthesia group were compared to evaluate factors determining the need for general anesthesia .Results: We analyzed 32 patients who received 285 irradiations. The median age was 5 years old (range: 1–15), and 13 patients (40.6%) were female. Twelve (37.5%) patients were treated with general anesthesia. In the general anesthesia group, airway management using laryngeal mask was performed in 11 patients (91.6%). Age was significantly lower in the general anesthesia group than in the non-anesthetized group (p < 0.001). Considering all background factors, only age was strongly associated with anesthesia in the univariate logistic regression models: odds ratio 0.55 [95% confidence interval 0.35–0.86] (P < 0.01). Adverse events included nausea and vomiting during and after irradiation, and no fatal complications were observed.Conclusion: Age is one of the most important factors determining the need for general anesthesia for PBT in children. it will be necessary to determine the guidelines for accumulation and collection of data between institutions and the indication of general anesthesia/sedation for radiation therapy including PBT.

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