Nationwide play-based programme helped children engage with paediatric radiotherapy

KEY POINTS

• The Mission of Brave was implemented across all seven paediatric radiotherapy centres in Hungary, enrolling 256 children aged 0–18 years between May 2023 and May 2026. Mean age was 10.3 years.
• The programme reframed radiotherapy as an astronaut mission using a preparation box containing a LEGO linear accelerator, storybook, activity booklet, personalised figurine, educational film, teddy bear, blanket, and symbolic treatment milestones.
• For children requiring head-and-neck immobilisation, staff painted thermoplastic masks as selected characters. Eighty-three children (32.4%) required masks, and 24 staff members volunteered to produce the customised designs.
• The programme was used across several treatment settings: 221 children received conventional linac treatment, 27 underwent total-body irradiation with cobalt-60, five received CyberKnife treatment, and three received online adaptive treatment on Ethos.
• Daily general anaesthesia was required in 53 children (20.7%). Among 25 children aged four to six years, staff attributed successful transition to fully conscious treatment in five cases (20%) to the structured preparation and play-based conditioning.
• Staff reported improved procedural familiarity, less crying or resistance, better immobilisation compliance, and reduced parental anxiety. These observations were qualitative and were not measured using validated anxiety scales, motion data, setup accuracy, or a control cohort.
• One child with severe autism developed sensory overload and hyperarousal from the treatment-room light projection, requiring immediate discontinuation of that component. This illustrates that environmental interventions require individual sensory assessment rather than universal application.

CLINICAL TAKEAWAY

SOURCE

Technical Innovations & Patient Support in Radiation Oncology