Paediatric Radiation Oncology (0 - 9 years)

How it works

The treatment of young children with cancer can be overwhelming for patients, parents and the treatment team. It requires a dedicated team of multidisciplinary experts to deliver precise radiotherapy safely and effectively – often in combination with systemic treatments like chemotherapy, targeted – or immunotherapy.

The treatment team usually consist of administrative, nursing, chemo- and radiotherapy personnel, oncologists and supportive medical / surgical specialities.

Radiation treatment usually happens once daily for a 4–6-week period. This can have a significant impact on a family in terms of logistics, travel and transport arrangements.

Process and timing

The process and timelines of paediatric radiotherapy are complicated. Young children (typically under 8-9 years) who are unable to lie still and cooperate during treatment may be given an anaesthetic or sedation. This is to ensure precise and consistently accurate treatment fractions. Treatment is usually administered once daily over a period of 4 to 6 weeks depending on age of the child, type of cancer and precise anatomical location of the tumour. The duration a child will be required to remain immobilised for treatment is usually 20-25 minutes.

Some of the challenges

Accuracy and precision

Delivering radiation therapy to paediatric patients requires high precision to minimise the radiation dose to healthy tissues and organs that are still developing. The radiation bunker at our unit is equipped with a new Varian Vitalbeam linear accelerator and we employ the latest AI empowered software to ensure that the highest precision and safety standards are met.

Treatment planning

Paediatric patients have different anatomical, physiological and biochemical characteristics compared to adults. This makes treatment planning complex. Factors such as the child’s growth, tissue composition, and ability to tolerate immobilisation devices like masks or moulds need to be considered to develop effective treatment plans. Unique radiotherapy tolerance tables used only for paediatric RT are essential to allow safe delivery of RT to cancer areas but safely avoid surrounding normal tissue at risk.

Long-term effects

Children undergoing radiation therapy are more susceptible to long-term effects due to their developing bodies. There is a need to balance delivering an effective treatment dose while minimising the risk of long-term complications, such as growth impairment, endocrinological sequelae, neurocognitive deficits, and secondary malignancies.

Psychology impact

The treatment of young children with cancer can be overwhelming for patients, parents, siblings and caretakers. Even the treatment team involved in providing care for little patients can find the process taxing. Crayon provides specialist paediatric radiation oncology services at our unit. All in a non-threatening and friendly environment.