Tumors in Children

The basic expected benefit of proton radiotherapy in pediatric oncology is a reducing the risk of toxicity. The target volumes, fractionation and timing of radiotherapy for individual subgroups of pediatric tumors are given in the relevant pediatric protocols. With proton radiotherapy, fractionation, volume and dose are identical as in the case of photon radiotherapy. The advantage of proton radiotherapy is to achieve higher conformity with a lower integral dose. Dose escalation of proton radiotherapy in pediatric patients is a potential advantage only very rarely, a typical example are cranial base chordomas, where in some cases it is impossible to apply a radical dose by photon radiotherapy.

PTC treatment protocols do not differ from commonly used pediatric protocols and the benefits of proton therapy stem from the physical principles of treatment. Proton therapy can:

• reduce the incidence of secondary malignancies.
• reduce the number of growth abnormalities.
• reduce the incidence of hormonal dysfunctions.
• reduce the incidence of cognitive impairment.
• reduce the incidence of acute side effects such as radiation mucositis, pneumonitis and gastroenteritis.