Guidelines for Pediatric Radiotherapy Simulation: A Report From the Children's Oncology Group Radiation Oncology Discipline
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.
Authors
- Arnold C. Paulino (ORCID: https://orcid.org/0000-0002-0269-3045)
- Thomas J. FitzGerald (ORCID: https://orcid.org/0000-0002-6256-0615)
- Parham Alaei (ORCID: https://orcid.org/0000-0003-4847-9068)
- Dana L. Casey (ORCID: https://orcid.org/0000-0001-6851-7653)
- Young Kwok (ORCID: https://orcid.org/0000-0003-1484-8507)
- Sujith Baliga (ORCID: https://orcid.org/0000-0002-8032-2071)
- Suzanne L. Wolden (ORCID: https://orcid.org/0000-0002-5234-4134)
- D. Haas-Kogan
- Natia Esiashvili (ORCID: https://orcid.org/0000-0002-7321-2034)
- Chia-Ho Hua
- Christine Hill‐Kayser
- Nadia N. Laack
- Sarah Milgrom
- John A. Kalapurakal
- Stephen Mihalcik
- Eric Ehler
- Christiane Burton
- John C. Breneman
Institutions
- Northwestern University (US)
- University of North Carolina at Chapel Hill (US)
- University of Maryland, Baltimore (US)
- St. Jude Children's Research Hospital (US)
- Rhode Island Department of Health (US)
- Mayo Clinic (US)
- Memorial Sloan Kettering Cancer Center (US)
- The University of Texas MD Anderson Cancer Center (US)
- Emory University (US)
- University of Massachusetts Chan Medical School (US)
- University of Minnesota System (US)
- Massachusetts General Hospital (US)
- University of Colorado Anschutz Medical Campus (US)
- The Ohio State University (US)
- University of Cincinnati (US)
- University of Pennsylvania (US)
Publication Details
- Journal
- Pediatric Blood & Cancer
- Published
- 2026-07-28
- DOI
- https://doi.org/10.1002/1545-5017.70460
- Primary Topic
- Neuroblastoma Research and Treatments
- Type
- article
- Field-Weighted Citation Impact
- 0.00