Page 163 - Organ motion in children for high-precision radiotherapy - Sophie Huijskens

estimation of population-based child-specific margins. The large individual variations underscore the need for a more individualized approach. For newer treatment delivery techniques daily image guidance in children is essential, which might in the future lead to adaptive approaches in pediatric radiotherapy to account for anatomical variations that occur over the course of treatment. Besides the application of an accurate safety margin to account for organ motion, other approaches and techniques are available and evolving rapidly to either manage or reduce organ motion (chapter 8). Although research on implementation of these techniques is mainly focused on adult cancer types, they could be potentially beneficial in children as well. Future prospective studies are needed to assess the potential clinical (and long-term) benefits of these techniques in children. Moreover, for techniques like proton and carbon ion therapy, where, compared to photon therapy, the very sharp dose fall-off of protons and carbon ions are even less forgiving for anatomical variations during treatment, accounting for organ motion is paramount. It is clear that radiotherapy is nowadays a rapidly evolving field in cancer care. New techniques and approaches are continuously improving and also need to be integrated in the pediatric clinical setting. This will eventually lead to high-precision radiotherapy and minimizing dose to surrounding healthy tissues. This will contribute to the ambition for higher survival rates and maximizing quality of life in childhood cancer survivors.
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