An evaluation of the use and efficacy of behavioural therapy when treating paediatric patients with radiation therapy.

Introduction: The paediatric radiation therapy group (PRTG) provided a multidisciplinary network to support patients accessing radiation therapy (RT). This study aims to evaluate the use and efficacy of behaviour therapy practices used by the PRTG.

Methods: A retrospective cross-sectional review of general anaesthetic (GA) utilisation for paediatric patients was completed between 1 January 2010 and 30 June 2014. The PRTG incorporated behavioural therapy techniques into all appointments but offered additional play appointments to children unable to comply with the requirements of RT. This aimed to increase their compliance and minimise GA use.

Results: Two-hundred and seventy-four patients had 5402 occasions of service, of which 1361 were delivered under GA (25.2%). Two-hundred and fifty-seven patients met the eligibility criteria. Patients under 8 years who required GA for their entire treatment reduced for each year of increase in age (odds ratio 0.37, 95% confidence interval 0.27-0.51, P < 0.001). Participants 3 years and younger were shown not as likely to change their GA requirements with the use of play appointments. Seventy-eight per cent (83/106) of 3-8-year-olds used no GA or ceased GA during treatment.

Conclusions: Most paediatric patients <3 years will gain minimal benefit to reduce GA use from additional play appointments. Children older than nine were not likely to require play appointments to be compliant with RT. Encouragingly, 53.3% of 3-8-year-olds who were categorised as full GA after CT planning did not continue to a full course of GA due to the behavioural therapy interventions of the PRTG.