The treatment for pediatric tumors requires interdisciplinary cooperation to integrate multimodality treatments. It could achieve optimal control rate of the primary lesion, reduce the probability of recurrence, and thereby improve survival. The common indications for radiotherapy:

a. For some of these radiosensitive tumors, definitive radiotherapy combined with chemotherapy is suggested. For example: CNS germ cell tumors, and early Hodgkin's lymphoma.

b. In the adjuvant settings, radiotherapy aims to eradicate the residual tumor at the primary lesion site and increase locoregional control. For example: primary CNS tumor, soft tissue sarcoma, neuroblastoma, and Wilms’ tumors.

c. As conditioning treatment, total body irradiation before a bone marrow transplant made the patient ready to accept a new and healthy stem cells and help remove the residual cancer cells.

d. Palliative radiotherapy could alleviate the discomforts caused by the tumor, such as compression of some unresectable, recurrence or metastatic tumor: inoperable sarcoma, recurrence lymphoma, retinoblastoma, craniopharyngioma, and other metastatic lesions. Last but not least, it is known that proton therapy has better dose distribution and causes less complications, compared with the photon therapy. However, tumor location and daily organ motion should be taken into consideration seriously. Proton dose distribution is very sensitive to the changes of treatment path length. Please have a detail discussion with your physician to adapt proton therapy.

Dr. Shih-Min Lin

Article Maintenance: Dr. Heng-Wei Kao