Presentation Description: There have been significant advances in the use of radiation for the management of pediatric malignancies over the last 10-15 years. In conjunction with advances in medical imaging, computer software, and linear accelerator hardware, radiation therapy has become significantly more accurate and more specific in delivering the high dose volume to the required tumour volume with much improved sparing of adjacent normal neural structures.
These advances have included CT/MR simulation, stereotactic radiotherapy, radiosurgery, Intensity Modulated Radiation Therapy (IMRT), and Image Guided Radiation Therapy (IGRT) with the use of CT which represent new technologies that are in the clinic today. Development and incorporation image guidance with the use of MRI and of molecular imaging techniques (Positron Emission Tomography (PET), MR spectroscopy, MR diffusion/permeability) will give us additional information as to the microscopic extent of tumour, and the use of these techniques during a course of radiation therapy will allow us to evolve our treatment to a so-called Adaptive Radiotherapy where frequent imaging during a 6 week course of RT will lead to a change in the high dose treatment volume eventually on a daily basis.
Normand J. Laperriere, MD, FRCPC, FRANZCR (Hon)
Department of Radiation Oncology
Princess Margaret Cancer Centre
Division of Hematology/Oncology
The Hospital for Sick Children, Toronto, ON