Experience of the Institute of Oncology and Radiology of Serbia in radiotherapy treatment of malignant tumors in children

Abstract

The Institute of Oncology and Radiology of Serbia in Belgrade is an institution in which the implementation of radiotherapy of children and adolescents started 35 years ago. To date, pediatric radiotherapy has been set up and has been following technological possibilities and progress, and a highly specialized multidisciplinary team has been established in the institution with a focus on pediatric oncology and radiotherapy. Purchase of equipment for three-dimensional conformal radiotherapy (3D-CRT) in 2006 enabled qualitative progress in the planning and implementation of pediatric radiotherapy. 60 to 80 patients aged 1 to 18 years are treated annually in our institution. For children aged up to 3 years, and in extremely rare cases older, radiotherapy is carried out in anesthesia, which is emphasized as a significant experience and quality of work of our institution. In the ten-year period from January 2007 to September 2016, 648 children were treated with radiotherapy. In the majority of children, 90.6%, radiotherapy was conducted using 3D conformal technique (3D-CRT) and in small number, 9.4% with conventional radiotherapy (2D-RT). The most frequent patients were children with central nervous system tumors 30.1%, leukemia 16.5%, bone tumors 15.4%, lymphoma 11.9%, soft tissue sarcoma 11.6%, neuroblastoma 6.5%, nephroblastoma 3.6%, retinoblastoma 1.7% and other rare tumors. Besides operative treatment, the majority of children were treated with chemotherapy and radiotherapy, 89.8%. Most of the children treated with radiotherapy were treated with chemotherapy in our institution, 45.8%. In a small number of children, radiotherapy was conducted as the only therapeutic approach, 10.2%. At the Institute for Oncology and Radiology of Serbia, as a central institution for pediatric radiotherapy, 3D-CRT has been fully adopted as a standard in the treatment of children and adolescents. In the past ten years, we have gained our own experiences which will be of great use to us with introduction of advanced techniques that we expect to gain by further purchase of machines and equipment for radiotherapy.