Treating the pediatric radiation oncology population has historically been difficult. Because it is imperative to have patients stay still during radiation treatment, general anesthesia is commonly used to facilitate radiation treatments in children, with most children age 7 and under receiving general anesthesia. This can cause many complications, difficulties, and detriments to the quality of life for patients because the regular course of radiation typically involves four to six weeks of daily treatment. Some of these setbacks include not being able to eat before treatments, a substantial increase in treatment time and recovery, potential health effects such as neurocognitive impairments from repeated doses of anesthesia, allergic reactions, more pronounced anxiety and fear, vascular access device complications, and a significant rise in financial burden. The stress that these patients and their families endure is tremendous and is amplified by the daily anesthesia – school schedules are severely disrupted, moods worsen because they cannot eat, and medical costs are high.
I have been very lucky to work with a group of talented physicists and physicians. So together we developed the hardware platform and also software tours we called promise which which stands for pediatric oncology with movie induced sedation effect. So I got this idea about 10 years ago when I was still at the University of California San Diego basically during the delivery of radiation treatment. You want the patients to stay still don't move for kids of like three year old or even younger or sometimes older. It's very challenging for them to stay there not moving at all for like 2030 minutes. So The typical way of treating those pediatric patients is to give them general anesthesia. And the treatment takes about 25 fractions or some sometimes 30 fractions. So when I saw that at the U. C. San Diego I was telling myself this is not right. You know this is terrible for this poor case and we have to do something. We have to develop something better to replace general anesthesia. So I started to think about it. Then I noticed you know we have parties with my students in my house. You know sometimes they bring their young kids there and the kids sitting in the living room watching tv watching the cartoons or whatever movies they like. So I realized that is actually can be used to replace or at least some sort of complimentary complimentary. Uh Tour to anesthesia. Uh So having to need general anesthesia every day with the vascular access could lead to infections. Uh Children can be more groggy long term there's potential neurocognitive consequences of having that many repeated anesthesia events. Uh So if we're able to avoid it, it could have improved outcomes in terms of health, but also for quality of life. So parents, Children, It's a lot to do that every day for several weeks. And so if we can avoid that, Children are much happier, they're able to eat. Uh they're in and out. They spend less than a half hour or 45 minutes here each day instead of several hours. Uh so families really appreciate not having to do anesthesia if we don't need it with promise. The process is completely different. Uh so you can come in as any other adult patient would come in just 15 minutes before your treatment time. Um And the child will meet with the physicists and with the therapist will go ahead and choose their favorite movie or the video that they want to watch. Um And they'll lie down on the table and the screen will be directly in front of their face and we'll start playing the video so immediately uh You know, most kids are happy to be here. They're excited to watch their favorite movie. Um And they can just focus on the movie and really not have to worry about the other things that are going on around them. Then we proceed with either the scan or the radiation treatment that takes at most 10:15 minutes. Uh and then you're done. And then the child was let off the table and they're free to go home soon after the treatment. So the primary system is a unique system. It's a link between the motion management and the been control systems and also a synchronized the being control signal to the movie content. The patient can be coached using the primary systems. They will receive the signal and instruction during the treatment like they are close to out of tolerance or they are out of tolerance. They have a chance to move back to the designated location without interrupting the treatment. The display device is really important in the radiation treatment because we cannot put anything between the being and the patient. It will affect the beings. But in our system the display devices made by the low radiation attenuation material. In other words, it won't affect the being quality in this case, it is really important because we can treat through all the treatment sites is not limited to the abdomen or pelvis. We also can treat through the device on head and cases