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Image-Guided Radiotherapy in Paediatrics: A Survey of International Patterns of Practice
Verna Wall1, Laure Marignol1, Nazmy ElBeltagi2
1Applied Radiation Therapy Trinity, Discipline of Radiation Therapy, School of Medicine, Trinity College Dublin, Dublin, Ireland.
Insights
Most radiation oncology centers lack specific image-guided radiation therapy (IGRT) protocols for pediatric patients. This highlights a need for age-specific guidelines to optimize treatment and reduce radiation exposure in children.
Area of Science:
- Radiation Oncology
- Medical Imaging
- Pediatric Cancer Treatment
Background:
- Image-guided radiation therapy (IGRT) is a standard treatment for various cancers in adults and children.
- Current international guidelines for optimal pediatric IGRT use are lacking.
- Understanding current practices is crucial for developing evidence-based recommendations.
Purpose of the Study:
- To evaluate and compare international practices in image-guided radiation therapy (IGRT) policies for pediatric versus adult patients.
- To identify disparities in IGRT protocol development and implementation between pediatric and adult oncology care.
- To assess the need for age-specific IGRT guidelines in pediatric radiotherapy.
Main Methods:
- An international survey was conducted among members of the International Paediatric Radiation Oncology Society.
- A five-item questionnaire focused on IGRT protocols for pediatric and adult patients.
- Data were collected from 43 responding centers worldwide.
Main Results:
- A majority of centers (65%) do not have distinct IGRT protocols for pediatric and adult patients.
- Imaging frequency was consistent for both age groups in 74% of centers.
- Scanning parameters differed for pediatric and adult central nervous system treatments in 47% of centers.
- Strategies to minimize radiation dose in pediatric IGRT were explored.
Conclusions:
- Most centers utilize site-specific IGRT protocols that do not account for patient age or size.
- There is a significant need for research to establish consensus guidelines for optimal pediatric IGRT.
- Developing age-tailored protocols is essential to reduce radiation exposure in pediatric patients.
Background And Purpose:
Image-guided radiation therapy (IGRT) is widely used in the treatment of various tumour types in both adult and paediatric patients. However, there are no international guidelines on its optimal use in paediatric radiotherapy. This study proposes to evaluate the current patterns of practice regarding IGRT policy in paediatric patients compared with adult patients through an international survey.
Materials And Methods:
A five-item questionnaire was created to address IGRT protocols for paediatrics and adults. International Paediatric Radiation Oncology Society members were eligible to partake and were contacted via email (number = 119).
Results:
Forty-three members have responded to the survey. Most (65%) centres did not have separate written IGRT protocols for paediatric and adult patients. The imaging frequency used was the same for adults and paediatrics in up to 74% of the centres responded, and scanning parameters used were different in adults and paediatrics in 47% of the centres for central nervous system treatment. Different measures to decrease exposure dose from IGRT in paediatrics have also been explored.
Conclusion:
Despite the extensive use of IGRT internationally, most centres use a series of site-specific protocols that fail to consider patient age or size. Given the desire to reduce radiation exposure in the paediatric patient cohort, further research is warranted to develop consensus guidelines on optimal IGRT use.
