The most common pediatric cancers involve the brain (brain tumors), immune system (leukemias and lymphomas), and connective tissue (bone sarcomas or soft-tissue sarcomas). Rare tumors include kidney cancer such as Wilms’ tumor and cancer of the peripheral nervous system such as neuroblastoma. Even rarer are cancers of the eye (retinoblastoma), liver (hepatoblastoma), and reproductive organs.
A weekly conference is held to consider cases of pediatric solid tumors and leukemia, as well as separate conferences on pediatric brain tumors and sarcomas. These conferences are attended by the radiation oncologists, pediatric surgeons, pediatric medical oncologists, pediatric neurosurgeons, orthopedic oncology surgeons, pathologists, radiologists, and support personnel. Joint decisions are made as to whether the child’s specific type of tumor and stage of disease are covered by a special treatment protocol, such as a COG (Children’s Oncology Group) protocol or a University of Florida protocol. If so, the treatment protocol is discussed with the patient’s family so they can decide whether to pursue this option. Alternative treatments are also discussed.
Role of Radiation Therapy for Children with Cancer
Radiation therapy is used predominately in children for tumors of the brain, bone, or soft tissue. These brain tumors and sarcomas are often dependent on radiation therapy for cure. The recommended treatment varies based on the exact site, stage, and type of cancer found. Often, chemotherapy is integrated with the radiation, as is surgery.
Types of Radiation Available
Pediatric radiation therapy at the University of Florida and Jacksonville University Medical Center is done primarily by Dr. Nancy Mendenhall, and Dr. Rashmi Benda. Patients are treated with combinations of external beams of radiation; this treatment is given 5 days a week, once or twice a day. Because the long-term effects of radiotherapy can be devastating, new techniques to minimize the potential long-term effects are utilized at the University of Florida. These include different methods of dividing the total radiation dose into one, two, or even three daily treatments (fractionation) and the use of new technology to prevent any unnecessary irradiation of tissues not involved with cancer.
The recommended treatment, the procedures to be carried out, and the expected benefits are all explained to the patient’s family. Based on this knowledge, informed consent for treatment can be given. The family must give permission before any treatment is started.
Number of Patients Treated Each Year
In general, approximately 50 to 100 children with pediatric cancers are given radiation therapy each year at the University of Florida’s Shands Cancer Center. Most of these patients are in early stages of disease.