Radiotherapy in pediatric patients without anesthesia or sedation: Feasibility and challenges

Conventionally fractionated radiotherapy treatment involves strict immobilization for accurate delivery and typically is delivered in five daily fractions every week for several weeks. To ensure rigid immobility during treatment planning and delivery in children, anesthesia or sedation has been used but valid concerns have been raised about the safety and long-term consequences of such practice on daily basis for prolonged periods. We tested the feasibility of avoiding daily anesthesia or sedation in our pediatric radiotherapy patients by extensive pretreatment counseling and demonstration of the treatment procedure ensuring their comfort and compliance.