title: [Towards an improvement of the quality of life after radiotherapy in children].
abstract: Pediatric radiotherapy did not differ technically from adult radiotherapy but its characteristics, its difficulties and challenges are specific. Thanks in part to this treatment, overall survival of French children with cancer is around 80%. It is therefore important to integrate in the elaboration of the treatment planning potential side long-term effects. Indeed, whatever the technique is, even the most sophisticated, it is usually inevitable that healthy nearby organs receive a dose of radiation. Dose limits on organs at risk come from adult data and are adapted for children. After the treatment, it is important to graduate the potential risks of side effects to propose a personalized monitoring protocol avoiding excessive medicalization. This article presents the medical thinking concerning radiotherapy in different anatomical areas (brain, head and neck, chest, abdomen) including concepts of dose level corresponding to side effects usually described. In parallel, we present follow-up recommendations with the aim to preserve an optimal quality of life for the adults cured of a childhood cancer, currently called survivors.
authors.affiliation: ICO-René-Gauducheau, institut de cancérologie de l'Ouest, service de radiothérapie, boulevard J-Monod, 44800 Saint-Herblain, France. Electronic address: charlotte.demoor@ico.unicancer.fr.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Demoor-Goldschmidt
authors.affiliation: Institut de cancérologie de Lorraine, département de radiothérapie, 6, avenue de Bourgogne, 54519 Vandœuvre lès Nancy, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Bernier
mesh_terms: D001921:Brain / Q000473:pathology / Q000528:radiation effects; D002561:Cerebrovascular Disorders / Q000209:etiology / Q000517:prevention & control; D002648:Child; D016371:Cranial Irradiation / Q000009:adverse effects; D004064:Digestive System / Q000528:radiation effects; D005500:Follow-Up Studies; D006321:Heart / Q000528:radiation effects; D006801:Humans; D008168:Lung / Q000528:radiation effects; D009369:Neoplasms / Q000532:radiotherapy*; D058958:Organs at Risk / Q000528:radiation effects*; D010388:Pelvis / Q000528:radiation effects; D011788:Quality of Life; D011832:Radiation Injuries / Q000150:complications*; D011879:Radiotherapy Dosage; D017741:Survivors
keywords: Abdomen; Adverse effects; Brain; Cerveau; Childhood; Cœur; Effets secondaires; Heart; Lung; Pediatric; Poumon; Pédiatrie; Radiotherapy; Radiothérapie