Clinical Applications of Particle Therapy in Pediatric Malignancies

In children, decades of survivorship magnify the harms of irradiation to normal tissues. Proton therapy (PT) leverages the Bragg peak phenomenon to maintain dose to tumor volumes while reducing dose to surrounding structures. This results in disease control comparable to photons while lowering normal tissue dose and reducing subsequent late effects. The clearest advantages occur when fields are large or when critical organs abut the target volume. Here, we discuss the clinical physics and comparative dosimetry that drive benefit across pediatric indications. We also synthesize PT outcomes for pediatric malignancies and highlight organ-specific late effects where PT reduces the incidence or severity of toxicities. We close with a brief look at the future of particle therapy for pediatric malignancies.