Thematic game intervention as a novel psychosocial support to reduce sedation needs and anxiety in pediatric neuro-oncology patients during radiotherapy: A prospective cohort study (2020–2025).

Abstract

10011 Background: Pediatric neuro-oncology patients undergoing radiotherapy frequently require sedation/anesthesia due to severe anxiety (mYPAS >15 in >80% cases) and treatment non-compliance. Conventional psychosocial interventions show limited efficacy in reducing sedation dependence, which incurs costs and clinical risks (e.g., respiratory depression). Methods: A prospective cohort study (2020–2025) of 246 children (3–5 years) receiving varied radiotherapy regimens (average course: ~30 fractions). Non-randomized allocation with propensity score matching for age, tumor stage, and sedation history: 1. Intervention group (n=122): Structured game-based intervention ("Radiation Warrior Training Camp"). 2. Control group (n=124): Standard psychological support. Primary outcomes: mYPAS anxiety scores, sedation/analgesia usage, treatment compliance, and cost savings (calculated at ¥376/session). Results: Sedation avoidance rate : 0% in intervention group vs. 41.1% in controls (OR=0.08, 95% CI [0.03–0.22], p<0.001). mYPAS score (median): 8.5 [6.8–3] vs. 17.1 [14.2–19.8] (β=-7.9, [-9.5,-6.3], p<0.001). Cost savings: ¥5,512/patient (derived from 82% relative sedation reduction × 30 fractions ×¥376/session). Treatment duration deviation reduced by 29% (p=0.011).Key Findings: 1. 92% of intervention patients completed radiotherapy without sedation. 2. Dose-dependent efficacy: Anxiety reduction correlated with gameplay duration (r=-0.71). 3. Developmental gradient: 5-year-olds achieved 9.2-point mYPAS reduction vs. 6.5-point in younger children. Conclusions: Game intervention eliminated sedation needs in 92% of patients, reducing anxiety by 7.9 mYPAS points and yielding ¥5,512/patient cost savings. This model demonstrates high clinical utility and economic efficiency for pediatric radiotherapy support.