Development of a smartphone virtual reality game to support the radiation therapy of children and adolescents in proton centers

Abstract

IntroductionFor most patients, cancer therapy with radiation is a new experience coming with many unknown challenges. This can be stressful, particularly for children and adolescents. With the aim of reducing this stress and anxiety, a virtual-reality (VR) game, which can be used by patients prior to treatment, was developed and evaluated in a proton therapy center.MethodsThe specifications were derived from literature and from interviews with medical staff and patients. The gantry including the sound of its moving components and the sound of the interlock and safety system were identified as the main features relevant for preparation of a radiation course. Potential implementation difficulties were identified in a literature study and regarded in the design. Within the VR game, patients could interact with modeled equipment of the treatment room and hear the reportedly stress-inducing sounds in a stress-free environment prior to the treatment. The VR game was evaluated in a second series of interviews with patients.Results and DiscussionThis exploratory study demonstrated the specification, implementation and safe application of a VR game dedicated to young proton therapy patients. Initial anecdotal evidence suggested that the VR gaming experience was well received and found to be helpful when preparing young patients for radiation therapy.

Investigating the Use of Serious Games for Cancer Control Among Children and Adolescents: Scoping Review

“…Children and adolescents were the main participants represented in the articles included in this review, which aligned with this study's purpose. The adolescents age group had the greatest representation in the included studies-all (8/8, 100%) cancer prevention serious game articles [7,34,[106][107][108][109][110][111] Cancer survivors [54,57,58,80,86,87,91] 0 (0) 7 ( 13) Health professionals [60,63,66,81,82,85,93,94,97] 0 (0) 9 ( 16)…”

“…Serious game preference [7,55,56,62,63,67,68,70,75,79,[84][85][86]90,[92][93][94][95][96][97][98][101][102][103][104]108,110,111] 4 (50) 24 (44) Treatment adherence [69,95,101] 0 (0) 3 ( 6) Cancer education [34,55,56,80,95,101,105,106,109] 3 (38) 6 (11) Healthy behavior promotion [42,54,57,60,65,74,…”

“…The majority of the included studies were published between 2019 and 2023. To be specific, 5 out of 8 (63%) cancer prevention serious game articles[7,106,[109][110][111] and 35 out of 55 (64%) cancer care serious game articles[35,42,54,58,59,[61][62][63]65,66,71,72,74,75,[78][79][80][81][82]85,[91][92][93][94][95][96][97][98][99][100][101][102][103][104][105] were published between 2019 and 2023. The studies were conducted in Asia, Europe, North America, and Oceania, with the majority of the studies being conducted in Europe and North America.…”

Supporting paediatric patients to receive radiation therapy without sedation or general anaesthetic

“…A further study was described by Schenck et al. 16 who developed a smartphone virtual reality game for children and adolescents receiving proton radiation therapy to reduce stress and anxiety.…”

“…The smartphone virtual reality game for children and adolescents receiving proton radiation therapy mentioned above was also developed after interviews with medical professionals and patients. 16 Arguably, qualitative research is needed as a first step in developing theoretically and empirically driven interventions for paediatric patients undergoing radiation therapy.…”