The Australian paediatric brachytherapy experience: A pathway to a national programme

Area of Science:

• Oncology
• Radiation Oncology
• Paediatric Medicine

Background:

• External beam radiation therapy (EBRT) is common for paediatric cancers but can cause late effects.
• Image-guided brachytherapy offers organ preservation and precise dose delivery to minimize toxicity.
• Brachytherapy is a specialized technique for treating paediatric pelvic tumours.

Purpose of the Study:

• To evaluate the feasibility and safety of paediatric brachytherapy for pelvic tumours.
• To compare brachytherapy plans with proton therapy plans.
• To assess treatment outcomes and toxicities in children receiving brachytherapy.

Main Methods:

• Retrospective review of 14 paediatric patients treated with brachytherapy between 2012-2022.
• Analysis of outcomes, toxicities, and comparison of brachytherapy versus proton plans in four patients.
• Predominant histology: rhabdomyosarcoma; all patients had pelvic tumours.

Main Results:

• 13 patients received high-dose rate (HDR) brachytherapy, one received low-dose rate (LDR).
• One grade 3 late toxicity and two cases of metastatic disease within one year were reported.
• Brachytherapy plans were superior or equivocal to proton plans in three of four patients.

Conclusions:

• This is the first Australian paediatric brachytherapy series from a single institution.
• Brachytherapy is feasible and safe for paediatric pelvic tumours.
• Comprehensive radiation plan review is crucial for selecting optimal treatment modalities.