Radiation therapy for children: Evolving technologies in the era of ALARA

Larry E. Kun, Chris Beltran

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

The evolution of ever more sophisticated oncologic imaging and technologies providing far more precise radiation therapy have combined to increase the utilization of sophisticated radiation therapy in childhood cancer. For a majority of children with common central nervous system, soft tissue, bone, and dysontogenic neoplasms, local irradiation is fundamental to successful multi-disciplinary management. Along with more precise target volume definition and radiation delivery, new technologies provide added certainty of patient positioning (electronic portal imaging, cone beam CT) and conformality of dose delivery (3-D conformal irradiation, intensity modulated radiation therapy, proton beam therapy). Each of the major areas of technology development are able to better confine the high-dose region to the intended target, but they are also associated with the potential for larger volumes of uninvolved tissues being exposed to low radiation doses. The latter issue plays a role in documented levels of secondary carcinogenesis, sometimes with greater anticipated incidence than that seen in conventional radiation therapy. Parameters related to carcinogenesis, such as dose-volume relationships and neutron contamination that accompanies high-energy photon irradiation and proton therapy, can be identified, sometimes modulated, and accepted as part of the clinical decision process in fine tuning radiation therapy in this more vulnerable age group.

Original languageEnglish (US)
JournalPediatric Radiology
Volume39
Issue numberSUPPL. 1
DOIs
StatePublished - Feb 1 2009

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Radiotherapy
Technology
Proton Therapy
Bone Tissue Neoplasms
Carcinogenesis
Radiation
Patient Positioning
Cone-Beam Computed Tomography
Neutrons
Photons
Central Nervous System
Age Groups
Incidence
Neoplasms

Keywords

  • Incidental radiation dose
  • Radiation therapy
  • Secondary carcinogenesis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Radiology Nuclear Medicine and imaging

Cite this

Radiation therapy for children : Evolving technologies in the era of ALARA. / Kun, Larry E.; Beltran, Chris.

In: Pediatric Radiology, Vol. 39, No. SUPPL. 1, 01.02.2009.

Research output: Contribution to journalArticle

Kun, Larry E. ; Beltran, Chris. / Radiation therapy for children : Evolving technologies in the era of ALARA. In: Pediatric Radiology. 2009 ; Vol. 39, No. SUPPL. 1.
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