Guidelines for Pediatric Radiotherapy Simulation: A Report From the Children's Oncology Group Radiation Oncology Discipline.

Authors

Parham Alaei, Stephen Mihalcik, Sujith Baliga, Young Kwok, Dana Casey, Eric Ehler, Christiane Burton, John C Breneman, Daphne A Haas-Kogan, Suzanne L Wolden, Arnold C Paulino, Nadia N Laack, Natia Esiashvili, Sarah Milgrom, Christine Hill-Kayser, Thomas J Fitzgerald, John A Kalapurakal, Chia-Ho Hua

Published in

Pediatric blood & cancer. Pages e70460. Jul 28, 2026. Epub Jul 28, 2026.

Abstract

Pediatric radiation therapy presents unique challenges compared to adult treatments, including those of immobilization, potential need for sedation, and the critical importance of accurate, reproducible positioning. Additionally, heightened attention to imaging doses is necessary to minimize long-term toxicity in survivors. Many of these challenges must be addressed during the process of simulation. This report provides guidelines for pediatric radiotherapy simulation from the Children's Oncology Group. These guidelines cover all anatomic sites and include recommendations for photon and proton therapies, as well as specialized procedures such as stereotactic body radiation therapy, brachytherapy, and total body irradiation. These guidelines are presented as recommendations rather than prescriptive standards as the practice will vary depending on patient age, diagnosis, clinical judgment, and institutional resources.

PMID:
42520295
Bibliographic data and abstract were imported from PubMed on 29 Jul 2026.

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