Radiation Exposure in Pediatric Sarcoma Patients Receiving Initial Curative Chemotherapy

Area of Science:

• Oncology
• Radiology
• Pediatric Medicine

Background:

• Pediatric patients with sarcoma undergo frequent ionizing radiation scans during chemotherapy.
• The cumulative radiation dose and diagnostic yield of these scans are not well-defined.

Purpose of the Study:

• To estimate radiation exposure in pediatric sarcoma patients undergoing mandated scans.
• To determine the frequency of detecting distant progressive disease via these scans.

Main Methods:

• Retrospective review of 5845 patients from Children's Oncology Group protocols (25 years).
• Analysis of common pediatric sarcomas: osteosarcoma, Ewing's sarcoma, rhabdomyosarcoma.
• Quantification of ionizing radiation scans (radiographs, CT, PET, bone scans) and total dose during chemotherapy.

Main Results:

• Average radiation dose was 37.1 mGy, comparable to nuclear power plant workers' lifetime dose.
• Disease progression was detected in only 5.4% of patients.
• Significant radiation exposure contrasts with low detection rates of disease progression.

Conclusions:

• Mandated surveillance scans in pediatric sarcoma patients result in substantial radiation exposure.
• The low detection rate of disease progression suggests a potential imbalance in risk-benefit for these scans.
• Findings aim to inform oncologists about the risks and benefits of surveillance imaging during chemotherapy.