Conformal Therapy for Pediatric Sarcomas

For decades, pediatric oncology has lead the field in the implementation of combined modality therapy and has tested indications for radiation therapy in this patient population. More recently, adult experiences with conformal methods of external beam irradiation and brachytherapy have refined radiation therapy as modality and increased its attractiveness as a means to achieve local control. These refinements come at a time when the current rates of local failure for advanced stage patients with pediatric solid tumors are significant enough to warrant a reexamination of the accepted indications for radiation therapy and its sequencing and dose. Conformal methods of radiation therapy, including brachytherapy, will facilitate efforts to improve local control. These methods have a special role in the pediatric patient where the potential for dose escalation, function preservation, and decreased toxicity can be used to the benefit of these patients, making the majority of them likely to be long-term survivors.