IGRT Commonly Used to Treat Pediatric Tumors

While image-guided radiation therapy (IGRT) is a commonly used modality to ensure treatment accuracy in the management of pediatric tumors, according to a study recently published in Practical Radiation Oncology, consensus recommendations are needed in order to guide clinical decisions on the use of IGRT in treating pediatric patients. The study evaluated the use of IGRT in treatment planning for pediatric cancers in an international consortium comprised of seven institutions using either photon or proton therapy with dedicated pediatric expertise. Nine international institutions were selected to participate in the consortium and were sent a 53-item survey comprised of mixed dichotomous, rank order, constant sum and open-ended questions to evaluate patterns of IGRT use in definitive radiation therapy for patients ≤21 years old. Seven of the nine institutions completed the survey. The seven institutions treated a total of approximately 750 pediatric patients, on average, per year. Five institutions use photon therapy alone, one uses proton therapy alone and one uses both photon and proton therapy. IGRT use also varied across consortium facilities depending on tumor type. All seven institutions used IGRT for treatment of ependymoma, abdominal and pelvic sarcoma, and rhabdomyosarcoma. Five facilities implemented IGRT for management of medulloblastoma, neuroblastoma and extremity sarcoma. Frequency of use and dose protocol varied among the sites. For example, of the four facilities that implemented a pediatric dose protocol, only one varied the dose protocol for different age groups within the pediatric population. Five consortium institutions cited image quality as the most important consideration when using IGRT for pediatric patients; one facility reported dose minimization as the primary consideration; and one facility reported both considerations were of equal importance. For more information on the study, click here.