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Pediatric Radiation Oncology with Movie Induced Sedation Effect (PROMISE) Radiation Therapy

T Chiu*, H Liu , M Joo , D Parsons , K Kumar , T Dan , S Jiang , X Gu , UT Southwestern Medical Center, Dallas, TX


(Monday, 7/15/2019) 4:30 PM - 6:00 PM

Room: Stars at Night Ballroom 2-3

Purpose: Aims to develop and implement an interactive movie incentive protocol integrated with the AlignRT gating system as an alternative sedation solution for pediatric radiotherapy.

Methods: During treatment, video is transferred by a wireless dongle and projected to a couch-indexed low attenuation screen (0.1-0.2%) directly in front of the patient. Due to low attenuation, the screen can be placed in the path of the beam with minimal interference. PROMISE is delivered using the following workflow: a) on the first fraction, a CBCT is acquired with AlignRT surface images and serves as reference images for subsequent fractions b) the AlignRT gating system and the PROMISE interactive movie is initiated c) during treatment, the PROMISE system will trigger warning/instructions when patients move close to tolerance based on changes in surface anatomy using AlignRT d) when the gating signal is triggered, the PROMISE system synchronizes both pausing of the movie and treatment e) when patients move back within tolerance, the PROMISE system resumes the movie and continues treatment.

Results: Pediatric patients between 6-to-10 years old evaluated for potential sedation requirement were treated with PROMISE in multiple disease sites, treatment times, and fractionation schedules. PROMISE was feasible to deliver abdominal, pelvic, or total body irradiation. Treatment times ranged from 8-30 min. No patients required sedation. The disagreement of initial setup error between CBCT and AlignRT (comparing to the reference image) were around 0.3mm (anterior-posterior), 0.9mm (superior-inferior) and 0.3mm (left-right). In-treatment variation was ~1.2mm with 0.8mm stand deviation from the reference base line.

Conclusion: PROMISE system offers an attractive alternative solution to anesthesia for children undergoing radiation therapy. It potentially reduces need for pediatric anesthesia and may be useful in minimizing patient motion. Additionally, it may diminish anxiety or distress associated with treatment and may also improve the overall patient experience.


Not Applicable / None Entered.


TH- RT Interfraction motion management : Development (new technology and techniques)

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