The Multidimensional Assessment for Pediatric Patients in Radiotherapy (M.A.P.-RT) Tool for Customized Treatment Preparation: RADAR Project

Silvia Chiesa; Elisa Marconi; Nicola Dinapoli; Maria Zoe Sanfilippo; Antonio Ruggiero; Angela Mastronuzzi; Giulia Panza; Annalisa Serra; Mariangela Massaccesi; Antonella Cacchione; Francesco Beghella Bartoli; Daniela Pia Rosaria Chieffo; Maria Antonietta Gambacorta; Vincenzo Valentini; Mario Balducci

doi:10.3389/fonc.2021.621690

The Multidimensional Assessment for Pediatric Patients in Radiotherapy (M.A.P.-RT) Tool for Customized Treatment Preparation: RADAR Project

Front Oncol. 2021 Mar 29:11:621690. doi: 10.3389/fonc.2021.621690. eCollection 2021.

Authors

Silvia Chiesa¹, Elisa Marconi^{1

2}, Nicola Dinapoli¹, Maria Zoe Sanfilippo³, Antonio Ruggiero^{3

4}, Angela Mastronuzzi⁵, Giulia Panza³, Annalisa Serra⁵, Mariangela Massaccesi¹, Antonella Cacchione⁵, Francesco Beghella Bartoli¹, Daniela Pia Rosaria Chieffo², Maria Antonietta Gambacorta^{1

3}, Vincenzo Valentini^{1

3}, Mario Balducci^{1

3}

Affiliations

¹ UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
² UOS di Psicologia Clinica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
³ Università Cattolica del Sacro Cuore, Rome, Italy.
⁴ UOC Pediatric Oncology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
⁵ Department of Paediatric Haematology/Oncology, IRCCS Bambino Gesù Children's Hospital, Rome, Italy.

Abstract

Aims: Pediatric patients may experience considerable distress during radiotherapy. Combining psychological interventions with standard therapies can reduce the need for sedation. The RADAR Project aims to use a systematic method of recording data that can reveal patients' difficulties and fragility during treatment. In this context, the aim of our study was to investigate the ability of a multidimensional assessment tool (M.A.P.-RT schedule) to predict the need for sedation during radiotherapy. The schedule, which is administered during the first evaluation, was created to collect information on patients and their families in a standardized way. Materials and Methods: The study enrolled pediatric patients (aged 0-18 years or 18-21 with cognitive impairment). Data were collected by means of the M.A.P.-RT module; this explores various thematic areas, and is completed by the radiation oncologist, psychologist and nurse during their first evaluation. Features were selected by means of the Boruta method (random forest classifier), and the totals of the significant partial scores on each subsection of the module were inserted into a logistic model in order to test for their correlation with the use of anesthesia and with the frequency of psychological support. The results of logistic regression (LR) were used to identify the best predictors. The AUC was used to identify the best threshold for the scores in the evaluation. Results: A total of 99 patients were considered for this analysis. The feature that best predicted both the need for anesthesia and the frequency of psychological support was the total score (TS), the AUC of the ROC being 0.9875 for anesthesia and 0.8866 for psychological support. Conclusion: During the first evaluation, the M.A.P.-RT form can predict the need for anesthesia in pediatric patients, and is a potential tool for personalizing therapeutic and management procedures.

Keywords: anesthesia; children; distress; pediatrics; psychological support; radiotherapy.