A modified technique for craniospinal irradiation in children designed to reduce acute and late radiation toxicity

Craniospinal irradiation is an important technique for the treatment of a number of paediatric malignancies. The conventional technique uses photons for all fields and does not exploit the benefits of CT and computer planning systems. The present paper describes a modification of the conventional technique in which both photons and electrons are used for the spinal field (mixed-beam technique). Computed tomography images and a planning computer are used for the selection of field junctions, electron beam energy and dosimetry. The intention of the technique is to reduce radiotherapy toxicity. A discussion of the potential benefits is presented.