WASPE Sleep Deprivation, Paired with an Optical Surface Monitoring System, Can Provide Accurate Radiation Therapy to Pediatric Patients Without the Need for Sedation

Pei Liu, Qingyu Huang, Tao Zhang, Xiang Zhang, Pengyue Shi, Liang Qi, Jinbo Yue

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: This study aimed to explore the use of a protocol for sleep deprivation, combined with a surface optical monitoring system (OSMS)-guided radiation therapy (RT) to eliminate the need for pharmaceutical sedation of pediatric patients with cancer. Methods and Materials: The study subjects were 28 children aged 0 to 3 years undergoing intensity modulated RT. Parents used the WASPE method to keep the children awake from 6:00 am to 2:00 pm on each day of RT. To compare the potential effects of sleep deprivation versus sedation on treatment, the first 16 patients tested were alternately sleep deprived 1 day and given sedatives the next day for the duration of the RT. In all cases, RT was delivered under the real-time guidance of an OSMS. Results: Twenty-seven of 28 children successfully completed 343 fractions of OSMS-guided RT. The 5-mm threshold for intrafractional motion was exceeded, and treatment was interrupted for patient repositioning during 13 sessions (sleep deprivation: 10 of 253 fractions; sedation: 3 of 90 fractions). Among the first 16 patients, no significant differences in inter- or intrafractional errors were noted on cone beam computed tomography scanning, except for an intrafractional error in the vertical direction for the 8th patient (P =.046). No significant difference in intrafractional errors measured by OSMS was found between the sleep-deprivation and sedation groups, except for 1 in the lateral direction for the 4th patient (P =.042) and 1 in the vertical direction for the 7th patient (P =.05). No differences were found in complete blood counts between the sleep-deprivation and sedation groups. In all, 36 of 52 parents surveyed (69%) preferred sleep deprivation, and only 3 parents (6%) preferred sedatives. Conclusions: The use of a sleep-deprivation protocol with OSMS guidance allows for accurate delivery of RT to children aged 0 to 3 years without the need for sedation and without jeopardizing target coverage. This approach may be useful for children who are resistant to or cannot tolerate sedatives.

Original languageEnglish
Pages (from-to)e292-e300
JournalPractical Radiation Oncology
Volume13
Issue number3
DOIs
StatePublished - 1 May 2023
Externally publishedYes

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