title: Preparation of pediatric patients for treatment with proton beam therapy.
abstract: OBJECTIVE
  Anesthesia is often used in proton beam therapy (PBT) for pediatric patients and this may prolong the treatment time. The aim of the study was to examine preparation of pediatric patients to allow smooth performance of PBT.
  
  
  METHODS
  Preparation was initiated 1-2days before treatment planning CT and continued for 10days. The patient first visited the facility to become familiar with the treatment room and staff. As the second step, the patient stayed in the treatment bed for a certain time with their mother, and then stayed on the treatment bed alone. Special fixtures painted with characters, music, and gifts were also prepared.
  
  
  RESULTS
  From 2010 to 2014, 111 pediatric patients underwent PBT. These patients were divided into 3 groups: 40 who could follow instructions well (group A, median age: 13.6years old), 60 who could communicate, but found it difficult to stay alone for a long time (group B, median age: 4.6years old), and 11 who could not follow instructions (group C, median age: 1.6years old). Preparation was used for patients in group B. The mean treatment times in groups A, B and C were 13.6, 17.1, and 15.6min, respectively, on PBT treatment days 2-6, and 11.8, 13.0, and 16.9min, respectively, for the last 5days of PBT treatment. The time reduction was significant in group B (p=0.003).
  
  
  CONCLUSIONS
  Preparation is useful for pediatric patients who can communicate. This approach allows PBT to be conducted more smoothly over a shorter treatment time.
authors.affiliation: Department of Radiation Oncology, Tsukuba University, Ibaraki, Japan. Electronic address: mizumoto1717@hotmail.com.
authors.forename: Masashi
authors.initials: M
authors.lastname: Mizumoto
authors.affiliation: Department of Radiation Oncology, Tsukuba University, Ibaraki, Japan.
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Oshiro
authors.affiliation: Proton Medical Research Center, Tsukuba University, Ibaraki, Japan.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Ayuzawa
authors.affiliation: Proton Medical Research Center, Tsukuba University, Ibaraki, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Miyamoto
authors.affiliation: Department of Radiation Oncology, Tsukuba University, Ibaraki, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Okumura
authors.affiliation: Department of Child Health, Tsukuba University, Ibaraki, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Fukushima
authors.affiliation: Department of Child Health, Tsukuba University, Ibaraki, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Fukushima
authors.affiliation: Department of Radiation Oncology, Tsukuba University, Ibaraki, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ishikawa
authors.affiliation: Department of Radiation Oncology, Tsukuba University, Ibaraki, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Tsuboi
authors.affiliation: Department of Radiation Oncology, Tsukuba University, Ibaraki, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Sakurai
mesh_terms: D000758:Anesthesia / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000532:radiotherapy*; D061766:Proton Therapy / Q000379:methods*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*
keywords: Anesthesia; Pediatric; Preparation; Proton beam therapy; Radiotherapy