Abstract
External beam radiation therapy (XRT) has become one of the cornerstones in the management of pediatric oncology cases. While the procedure itself is painless, the anxiety it causes may necessitate the provision of sedation or anesthesia for the patient. This review paper will briefly review the XRT procedure itself so that the anesthesia provider has an understanding of what is occurring during the simulation and treatment phases. We will then examine several currently used regimens for the provision of pediatric sedation in the XRT suite as well as a discussion of when and how general anesthesia should be performed if deemed necessary. Standards of care with respect to patient monitoring will be addressed. We will conclude with a survey of the developing field of radiation-based therapy administered outside of the XRT suite.
Highlights
Cancer continues to be a leading cause of pediatric mortality in the developed world, with physicians and scientists constantly developing new weapons to combat it
Since radiation therapy is a painless procedure, many older patients can complete their treatment without the use of anesthesia or sedation
Babies and younger toddlers are not receptive to such enticement, and these are the patients that make up the vast majority of XRT anesthesia cases
Summary
Cancer continues to be a leading cause of pediatric mortality in the developed world, with physicians and scientists constantly developing new weapons to combat it. Chemotherapy, surgery, nutrition, and holistic medicine all have a place in the multimodal approach that can prolong longevity and ameliorate quality of life. As part of this armamentarium, external beam radiation therapy (XRT) has proven to be a safe and effective technique for the management of various malignant (and occasionally nonmalignant) lesions. Since radiation therapy is a painless procedure, many older patients can complete their treatment without the use of anesthesia or sedation. Babies and younger toddlers are not receptive to such enticement, and these are the patients that make up the vast majority of XRT anesthesia cases. Indicators that suggest the need for anesthesia include young age, anxiety, treatment complexity (e.g., prone position), emotional immaturity for age, and a history of noncompliance [3]
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