Modern trends in photon radiation therapy in pediatric practice

New technologies in radiation therapy (RT) are rapidly developing and entering the clinical practice of leading clinics. Pediatricians, pediatric oncologists, hematologists and other physicians are in need of understanding of the main trends in the development of modern RT in pediatric practice. The Article describes the main modern methods of photon radiation therapy (PRT) and of RT with intensity modulation and image control in particular, considers the methods of adaptive and stereotaxic RT. The urgent need for a reference evaluation of irradiation of pediatric patients’ plans is demonstrated as well. Thus, according to the reference evaluation results of 270 plans from 40 clinics, it was found that gross errors in target contouring were found in 39% of cases, the plan that could not be accepted for treatment in 40%. Modern PRT has wide technological capabilities, however, for its more effective use for the benefit of patients it is necessary to create a unified national database of RT plans. Only an analysis of the new data can make it possible to take more balanced approach to planning exposure in children, to provide dose reduction/escalation in patients of various prognostic groups taking into account the likelihood of undesirable late effects.