The Multidimensional Assessment for Pediatric Patients in Radiotherapy (M.A.P.-RT) Tool for Customized Treatment Preparation: RADAR Project

Abstract

Aims: Pediatric patients may experience considerable distress during radiotherapy. Combining psychological interventions with standard therapies can reduce the need for sedation. The RADAR Project aims to use a systematic method of recording data that can reveal patients' difficulties and fragility during treatment.In this context, the aim of our study was to investigate the ability of a multidimensional assessment tool (M.A.P.-RT schedule) to predict the need for sedation during radiotherapy. The schedule, which is administered during the first evaluation, was created to collect information on patients and their families in a standardized way.Materials and Methods: The study enrolled pediatric patients (aged 0–18 years or 18–21 with cognitive impairment). Data were collected by means of the M.A.P.-RT module; this explores various thematic areas, and is completed by the radiation oncologist, psychologist and nurse during their first evaluation. Features were selected by means of the Boruta method (random forest classifier), and the totals of the significant partial scores on each subsection of the module were inserted into a logistic model in order to test for their correlation with the use of anesthesia and with the frequency of psychological support. The results of logistic regression (LR) were used to identify the best predictors. The AUC was used to identify the best threshold for the scores in the evaluation.Results: A total of 99 patients were considered for this analysis. The feature that best predicted both the need for anesthesia and the frequency of psychological support was the total score (TS), the AUC of the ROC being 0.9875 for anesthesia and 0.8866 for psychological support.Conclusion: During the first evaluation, the M.A.P.-RT form can predict the need for anesthesia in pediatric patients, and is a potential tool for personalizing therapeutic and management procedures.

Survey of Anesthesia, Sedation, and Non-sedation Practices for Children Undergoing Repetitive Cranial or Craniospinal Radiotherapy

“…Perhaps more challenging is the ability to predict patient compliance during radiotherapy without anesthesia. To this end, Chiesa et al described the accuracy of a multidimensional assessment tool in identifying which children were more likely to be unable to complete radiotherapy without sedation [21].…”

“…The importance of a multidisciplinary approach to the success and safety of pediatric radiotherapy is welldocumented [21]. However, as the current survey demonstrates, anesthesiologists are often not invited to discuss patient care concerns, and radiotherapy facility infrastructure-related obstacles to anesthetic management persist (Tables 4-5).…”

“…At your institution, who has the leadership role in creating the daily anesthesia/sedation schedule for radiotherapy? Please specify how late in the day the last pediatric radiotherapy case is scheduled 21…”

Integration of art and technology in personalized radiation oncology care: Experiences, evidence, and perspectives

“…The project uses assessment tools, such as the Multidimensional Assessment for Pediatric patients in Radiotherapy - MAP-RT schedule ( 58 ), age-appropriate psychological preparation and psychological support, creative activities, and digital tools. All these interventions increasingly try to put the patient/family at the center by fostering engagement and co-creation processes in RT.…”

The Italian Version of the Pediatric Quality of Life Inventory™ (Pedsql™) 3.0 Healthcare Satisfaction Hematology/oncology Module: Reliability and Validity in Radiation Oncology

“…During radiation therapy care path, pediatric patients and their relatives may suffer from emotional and psychosocial distress not only related to cancer diagnosis, but also due to the procedure and the required daily routine. [21][22][23][24] Despite the high prevalence of psychosocial consequences of pediatric cancer in patients and their relatives, instruments that inquire pediatric HRQOL and healthcare satisfaction have rarely been studied in Italy.…”