Initial clinical outcomes of Audio-Visual Assisted Therapeutic Ambience in Radiotherapy (AVATAR)

Publication date: Available online 19 January 2017
Source:Practical Radiation Oncology
Author(s): Susan M. Hiniker, Karl Bush, Tyler Fowler, Evan C. White, Samuel Rodriguez, Peter G. Maxim, Sarah S. Donaldson, Billy W. Loo
PurposeRadiation therapy is an important component of treatment for many childhood cancers. Depending upon the age and maturity of the child, pediatric radiation therapy often requires general anesthesia for immobilization, position reproducibility, and daily treatment delivery. We designed and clinically implemented a radiation therapy compatible audio-visual system allowing children to watch streaming video during treatment with the goal of reducing the need for daily anesthesia through immersion in video.Materials/MethodsWe designed an Audio-Visual Assisted Therapeutic Ambience in Radiotherapy (AVATAR) system using a digital media player with wireless streaming and pico projector, and a radiolucent display screen positioned within the patient's field of view to provide the child with sufficient entertainment and distraction for the duration of serial treatments without the need for daily anesthesia. We piloted this system in 25 pediatric patients between the ages of 3–12years. We calculated the number of fractions of radiation for which this system was used successfully and anesthesia avoided, and compared it to reported anesthesia rates in the literature for children of this age.ResultsTwenty-three of 25 patients (92%) were able to complete the prescribed course of radiation therapy without anesthesia using the AVATAR system, with a total of 441 fractions of treatment administered using AVATAR. The median age of patients successfully treated with this approach was 6years. Seven of the 23 patients were initially treated with daily anesthesia and were successfully transitioned to use of the AVATAR system. Patients and families reported an improved treatment experience with the use of the AVATAR system as compared to anesthesia.ConclusionThe AVATAR system enables a high proportion of children to undergo radiation therapy without anesthesia when compared to reported anesthesia rates, justifying continued development and clinical investigation of this technique.



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