Image-Guided Radiotherapy in Paediatrics: A Survey of International Patterns of Practice

BACKGROUND AND PURPOSE:Image-guided radiation therapy (IGRT) is widely used in the treatment of various tumour types in both adult and paediatric patients. However, there are no international guidelines on its optimal use in paediatric radiotherapy. This study proposes to evaluate the current patterns of practice regarding IGRT policy in paediatric patients compared with adult patients through an international survey. MATERIALS AND METHODS:A five-item questionnaire was created to address IGRT protocols for paediatrics and adults. International Paediatric Radiation Oncology Society members were eligible to partake and were contacted via email (number = 119). RESULTS:Forty-three members have responded to the survey. Most (65%) centres did not have separate written IGRT protocols for paediatric and adult patients. The imaging frequency used was the same for adults and paediatrics in up to 74% of the centres responded, and scanning parameters used were different in adults and paediatrics in 47% of the centres for central nervous system treatment. Different measures to decrease exposure dose from IGRT in paediatrics have also been explored. CONCLUSION:Despite the extensive use of IGRT internationally, most centres use a series of site-specific protocols that fail to consider patient age or size. Given the desire to reduce radiation exposure in the paediatric patient cohort, further research is warranted to develop consensus guidelines on optimal IGRT use.