Обзор состояния брахитерапии на современном этапе развития детской онкологии

Abstract

This article, based on an analysis of the results of the work of leading cancer centers in the world, provides an overview of the possibilities of brachytherapy in the treatment of malignant tumors in children, presents indications for brachytherapy at the present stage of development of pediatric oncology. Malignant neoplasms in children are relatively rare, with an annual frequency of 13–14 cases per 100,000 children under the age of 15 years and make up less than 1\xa0% of all cancer cases in developed countries. In the treatment of tumors in children, as a rule, a multimodal (integrated) approach is used. A treatment program usually includes surgery, chemotherapy, and external radiation therapy. Treatment strategies aimed at reducing late side effects have significantly increased interest in brachytherapy, in particular in the treatment of soft tissue sarcoma and clear cell adenocarcinoma, since in these malignant neoplasms only a limited target volume should receive a significant radiation dose, often exceeding the tolerant doses of the surrounding swelling of normal tissues and structures. The article contains the following sections: •\xa0 Introduction •\xa0 Methodological aspects of brachytherapy in children •\xa0 Clinical indications for the use of brachytherapy in children, depending on tumor localization › Brachytherapy of clear cell adenocarcinoma in children › Technique for brachytherapy in children › Total focal dose, dose rate and fractionation of brachytherapy in children •\xa0 Conclusions