الفهرس 
Fundamentals of External Beam Radiotherapy (EBRT)Only 14 pages are availabe for public view
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Abstract
Background: Along with surgery, chemotherapy, and nutrition, radiation therapy is a cornerstone in the multimodal management of pediatric cancer. Children with brain tumors, sarcomas of bone and soft tissues, neuroblastoma, Wilms tumor, and Hodgkin lymphoma are commonly treated with radiation therapy. The aim of radiation therapy is to deliver tumoricidal doses of radiation to areas of overt and microscopic tumor while limiting damage to adjacent normal tissues. External beam radiotherapy (XRT or EBRT) is the most commonly used type of radiation therapy. Although painless, there is a requirement for the child to lie still by themselves in the radiation treatment room, for multiple daily or twice daily treatments for up to 6 weeks. General anesthesia or sedation is usually necessary to achieve this in younger children. In children older than age 7 or 8 years, it is often possible to perform radiotherapy without sedation. This may be accomplished in younger children with behavioral rehearsal and distraction techniques.
Objectives: The aim of work is performing sedation or anesthesia in pediatric patients undergoing radiation therapy and to highlight the difficulties of performing procedural sedation outside the operative room and attempt to explore some of the ways to improve safety.
Conclusion: Many anesthesia techniques and agents have been used over the years to sedate or anesthetize children during radiation therapy. Agents such as ketamine, midazolam, chloral hydrate, dexmedetomidine, propofol or a combination were often used for sedation. General anesthesia with inhalational agents (halothane, sevoflurane) has been also used, but often requires an airway device of some kind (endotracheal tube, laryngeal mask). The anesthesiologist must have proper knowledge of the doses, indications, contraindications, side effects and complications of the different drugs used in sedation or anesthesia.