QLTI-12. Association of Thematic Game Intervention with Anxiety Reduction and Treatment Compliance in Pediatric Neuro-Oncology Patients During Radiotherapy: A Prospective Cohort Study

BACKGROUND Pediatric neuro-oncology patients undergoing radiotherapy frequently experience anxiety and suboptimal treatment compliance‌1. Traditional interventions (e.g., pharmacological sedation) carry risks such as respiratory depression, while psychological support often yields limited efficacy‌. Emerging evidence highlights gamified interventions as promising non-pharmacological alternatives, yet their application in radiotherapy settings remains underexplored‌. OBJECTIVE ‌ To evaluate the impact of personalized thematic game interventions on anxiety levels, treatment cooperation, and quality of life in pediatric neuro-oncology patients during radiotherapy‌. METHODS ‌ This prospective cohort study enrolled 62 children aged 3–5 years requiring whole-brain radiotherapy. Participants were non-randomly allocated to two cohorts: the intervention cohort (n=31, receiving radiotherapy-themed games, e.g., “Radiation Warrior Training Camp”) and the routine-care cohort (n=31, receiving standard psychological support). Propensity score matching adjusted for baseline age, tumor stage, and prior sedation exposure. Outcomes included anxiety (modified Yale Preoperative Anxiety Scale, mYPAS 0–22), sedation usage, treatment duration deviation (actual/planned ratio), and heart rate. Linear mixed models and logistic regression were employed for analysis‌. RESULTS Anxiety:‌ The intervention cohort exhibited lower adjusted mYPAS scores (β = -7.6, 95% CI: -9.2 to -5.9, p < 0.001), with median scores of 8.2 [IQR 6.5–10.1] vs. 16.8 [13.4–19.3]‌. SEDATION ‌ Reduced sedation odds were observed in the intervention cohort (OR = 0.24, 95% CI: 0.09–0.62, p = 0.004), with absolute rates of 19.4% vs. 56.5%‌. EFFICIENCY ‌ The intervention cohort demonstrated smaller treatment duration deviations (adjusted ratio 1.12 ± 0.23 vs. 1.57 ± 0.41, p = 0.018)‌12. PHYSIOLOGICAL RESPONSE ‌ Mean heart rate decreased by 18.6 bpm in the intervention cohort (94.3 ± 11.2 vs. 112.9 ± 13.4, p < 0.001)‌. CONCLUSION ‌ Thematic game interventions, through immersive task design and procedural synchronization, effectively mitigate radiotherapy-related anxiety, enhance treatment compliance, and improve quality of life in pediatric neuro-oncology patients‌13. These findings advocate for integrating gamified prehabilitation into pediatric radiotherapy protocols. Future studies should optimize game adaptability and evaluate long-term outcomes‌.