title: [Improvement in function-preservation in radiotherapy for pediatric malignancies].
abstract: In radiotherapeutic management for pediatric tumors, we have to pay more attention to confinement of higher dose to the target volume than for adult tumors, in order that the risk of untoward normal tissue complications dose not increase, such as growth retardation. Two current approaches performing in our department to match this purpose are presented, namely, perioperative brachytherapy and fractionated stereotactic radiotherapy (F-SRT). In perioperative brachytherapy for bone and soft tissue sarcoma, plastic guide tubes for introducing radioactive sources are placed in the residual tumor bed or at the margins during the surgery, and patients are treated by high-dose-rate brachytherapy after surgery. Patients are not restricted in radioprotective area, and the overall treatment period is short enough. F-SRT is used either as the boost of conventional brain radiotherapy in primary brain neoplasms, or as hypofractionated F-SRT for control of metastatic brain tumors, with nearly perfect local control and maintenance of good quality of life. F-SRT is planned in 3-dimensional fashion from computed tomography images. Easily detachable, relocatable cast made for F-SRT is useful in pediatric patients.
authors.affiliation: Dept. of Radiation Therapy, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Sumi
authors.forename: H
authors.initials: H
authors.lastname: Ikeda
authors.forename: K
authors.initials: K
authors.lastname: Tokuuye
authors.forename: Y
authors.initials: Y
authors.lastname: Kagami
authors.forename: S
authors.initials: S
authors.lastname: Murayama
authors.forename: S
authors.initials: S
authors.lastname: Shibui
authors.forename: Y
authors.initials: Y
authors.lastname: Inoo
authors.forename: H
authors.initials: H
authors.lastname: Oyama
authors.forename: K
authors.initials: K
authors.lastname: Nomura
authors.forename: Y
authors.initials: Y
authors.lastname: Beppu
authors.forename: R
authors.initials: R
authors.lastname: Yokoyama
authors.forename: H
authors.initials: H
authors.lastname: Fukuma
authors.forename: J
authors.initials: J
authors.lastname: Takayama
authors.forename: M
authors.initials: M
authors.lastname: Ohira
mesh_terms: D001918:Brachytherapy / Q000379:methods*; D001932:Brain Neoplasms / Q000503:physiopathology / Q000532:radiotherapy*; D002648:Child; D006801:Humans; D011879:Radiotherapy Dosage; D012509:Sarcoma / Q000532:radiotherapy; D012983:Soft Tissue Neoplasms / Q000532:radiotherapy; D013238:Stereotaxic Techniques