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Proton therapy for pediatric cancer: are we ready for prime time?


The majority of pediatric oncology patients become long-term survivors who must live with the effects of their diseases and treatments for many decades [1]. Although there is a trend toward reduced use of radiation therapy in children with cancer, it continues to play an essential role in the treatment of many common pediatric malignancies, including brain tumors, sarcomas, lymphomas and neuroblastoma [2]. Therefore, it is imperative to deliver effective radiation therapy with the least morbidity possible in the treatment of children with cancer. Proton beam therapy (PBT) is promising for its potential to provide equivalent efficacy in treating pediatric cancer patients with improved acute and late side-effect profiles due to the lack of exit dose from its beams.

Most pediatric cancer patients in the USA (and worldwide) require radiotherapy receive photon (or electron) radiation, however, the use of PBT is growing. Fifteen years ago, there were two clinical PBT facilities, both treating pediatric patients in the USA; now there are 23 PBT centers, the majority of which treat children [3]. More pediatric cancer patients are being treated with PBT, including an increase of 33% between 2010 and 2012 [4].

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