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Guidelines for Pediatric Radiotherapy Simulation: A Report From the Children's Oncology Group Radiation Oncology
Parham Alaei1, Stephen Mihalcik2, Sujith Baliga3
1University of Minnesota, Minneapolis, Minnesota, USA.
Pediatric Blood & Cancer
|July 28, 2026
Summary
This report offers guidelines for pediatric radiation therapy simulation, addressing unique challenges in immobilization, sedation, and precise patient positioning. It aims to minimize imaging doses and long-term toxicity for pediatric cancer survivors.
Area of Science:
- Radiation Oncology
- Pediatric Oncology
- Medical Imaging
Background:
- Pediatric radiation therapy faces unique challenges including immobilization, sedation, and precise patient positioning.
- Minimizing imaging doses is crucial to reduce long-term toxicity in pediatric cancer survivors.
- Simulation is a critical step in addressing these challenges.
Purpose of the Study:
- To provide comprehensive guidelines for pediatric radiotherapy simulation.
- To cover all anatomic sites and various treatment modalities.
- To offer recommendations for photon and proton therapies, and specialized procedures.
Main Methods:
- Development of guidelines by the Children's Oncology Group.
- Inclusion of recommendations for diverse treatment types: photon, proton, stereotactic body radiation therapy, brachytherapy, and total body irradiation.
- Consideration of patient age, diagnosis, clinical judgment, and institutional resources.
Main Results:
- Guidelines encompass all anatomic sites for pediatric radiotherapy simulation.
- Recommendations are provided for both photon and proton therapies.
- Specialized procedures like SBRT, brachytherapy, and TBI are addressed.
Conclusions:
- The guidelines offer a framework for pediatric radiotherapy simulation.
- Recommendations are flexible, acknowledging variability in patient and institutional factors.
- Focus on accurate positioning and dose reduction to improve outcomes for pediatric patients.
