Fernández-de Miguel José M, García-Aroca Miguel Ángel, Manrique Yera Ignacio, Calvo Felipe A, Aymerich de Francesci María, Álvarez Avello Jose Manuel, Panizo Morgado Elena, Núñez-Córdoba Jorge M
Department of Anaesthesia and Critical Care, Clínica Universidad de Navarra, Madrid, Spain.
Department of Anesthesia and Intensive Care, HCD "Gómez-Ulla", Madrid, Spain.
Clin Transl Oncol. 2025 Jun 19. doi: 10.1007/s12094-025-03972-4.
Due to the labor intensity demanded by proton beam therapy (PBT) in pediatric patients, information on operational procedures related to efficiency is crucial to optimize quality and safety. We aimed to identify patient factors that affect the duration of the pediatric PBT session and to develop an easy-to-use predictive score of extended duration.
METHODS/PATIENTS: This is an observational retrospective cohort study in an academic medical centre, between May 2020 and February 2024. Seventy seven ASA III pediatric patients treated with PBT were recruited.
The mean age was 4.8 years [standard deviation (SD): 2.1] and 52% were women. The mean duration of the PBT session was 50 min (SD: 17). Extended duration of the PBT session (> 45 min) occurred in 39 patients (51%). Five predictors of extended duration were selected for the final prediction model. In the multivariable model, an age > 45 months showed a near eightfold increased odds of extended duration [Odds ratio (OR): 7.76, 95% confidence interval (95% CI) 1.63-36.99, P = 0.010]. The OR (95% CI) for long-term venous access, no recurrent tumors, hydrocephalus, and craniospinal location were 5.91 (1.47 to 23.79), 3.81 (0.67 to 21.69), 3.79 (0.90 to 15.97), and 2.59 (0.69 to 9.76), respectively. This five-variable model was used to build a nomogram-based score with an area under the receiver operating characteristic curve of 0.84 (95% CI 0.76-0.93).
A simple nomogram based on readily available pretreatment data has potential for planning pediatric PBT standard clinical expert practice.
由于质子束治疗（PBT）对儿科患者要求的劳动强度，与效率相关的操作程序信息对于优化质量和安全性至关重要。我们旨在确定影响儿科PBT疗程持续时间的患者因素，并开发一种易于使用的延长疗程预测评分。
方法/患者：这是一项在学术医疗中心进行的观察性回顾性队列研究，时间跨度为2020年5月至2024年2月。招募了77例接受PBT治疗的ASA III级儿科患者。
平均年龄为4.8岁[标准差（SD）：2.1]，52%为女性。PBT疗程的平均持续时间为50分钟（SD：17）。39例患者（51%）出现PBT疗程延长（>45分钟）。最终预测模型选择了五个延长疗程的预测因素。在多变量模型中，年龄>45个月显示延长疗程的几率增加近八倍[比值比（OR）：7.76，95%置信区间（95%CI）1.63 - 36.99，P = 0.010]。长期静脉通路、无复发性肿瘤、脑积水和颅脊髓部位的OR（95%CI）分别为5.91（1.47至23.79）、3.81（0.67至21.69）、3.79（0.90至15.97）和2.59（0.69至9.76）。这个五变量模型用于构建基于列线图的评分，受试者操作特征曲线下面积为0.84（95%CI 0.76 - 0.93）。
基于易于获得的预处理数据的简单列线图有潜力用于规划儿科PBT标准临床专家实践。
