Pediatric Radiotherapy Department: Recommendations for optimal infrastructure and personnel

Abstract

In multidisciplinary treatment of malignant diseases in pediatric population, radiotherapy with or without surgery, represents the basic modality of local treatment. Although the basic principles of radiotherapy in children are the same as in adults, it has its own specificity because it is applied to an organism in the phase of growth and development. Also, pediatric tumors differ from tumors in adults, so pediatric radiation oncologist has to have knowledge of pediatric oncology. Treatment of children with malignant diseases requires coordinated work of a multidisciplinary team: radiation oncologist, pediatrician, various specialty surgeons, pathologists, each of whom participates in the decision making on combined oncological treatment. Treatment decisions are necessary made in a multidisciplinary environment with the necessary knowledge of all members of the pediatric oncology team. Pediatric radiation oncology has its specifics and requirements in terms of infrastructure and organization. The basic requirements apply to rooms, equipment, staff, and procedures. Based on the international recommendations, the necessary radiotherapy equipment and its number, for the work with children, is defined. In the treatment of children it is recommended to use 3D conformal radiotherapy, or other advanced techniques, in order to avoid the irradiation of healthy tissues as much as possible. Monitoring early and late unwanted effects of radiotherapy is of great importance in treating children with malignant tumors. Also, a certain level of knowledge in the pathology of malignant diseases of children is necessary of all the members of radiotherapy team. Pediatric radiotherapy, as an extremely sophisticated and complex method of treatment, can therefore only be performed in hospitals and centers that can meet all of the above high standards and recommendations with the coordinated work of a multidisciplinary team with experience in pediatric oncology.