C Demoor-Goldschmidt1, L Claude2, C Carrie2, S Bolle3, S Helfre4, C Alapetite4, A Jouin5, L Padovani6, A Ducassou7, C Vigneron8, É Le Prisé9, A Huchet10, D Stefan11, C Kerr12, T-D Nguyen13, G Truc14, S Chapet15, P-Y Bondiau16, B Coche5, X Muracciole6, A Laprie7, G Noël8, J Leseur9, J-L Habrand11, H Potet13, A Ruffier15, S Supiot17, M-A Mahé17, V Bernier8. 1. Radiothérapie, institut de cancérologie de l'Ouest-Nantes, boulevard Jacques-Monod, 44800 Saint-Herblain, France; Inserm U1018, rue Édouard-Vaillant, 94800 Villejuif, France. Electronic address: charlotte.demoor@inserm.fr. 2. Radiothérapie, centre Léon-Bérard, 28, promenade Léa-et-Napoléon-Bullukian, 69008 Lyon, France. 3. Radiothérapie, institut Gustave-Roussy, 114, rue Édouard-Vaillant, 94800 Villejuif, France. 4. Radiothérapie, institut Curie, 26, rue d'Ulm, 75005 Paris, France. 5. Radiothérapie, centre Oscar-Lambret, 3, rue Frédéric-Combemale, 59000 Lille, France. 6. Radiothérapie, Assistance publique-Hôpitaux de Marseille, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France. 7. Radiothérapie, IUCT Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse, France. 8. Radiothérapie, centre Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, 67000 Strasbourg, France. 9. Radiothérapie, centre Eugène-Marquis, avenue de la Bataille-Flandres-Dunkerque, 35000 Rennes, France. 10. Radiothérapie, hôpital Haut-Lévêque, CHU de Bordeaux, avenue de Magellan, 33604 Pessac, France. 11. Radiothérapie, centre François-Baclesse, 3, avenue du Général-Harris, 14000 Caen, France. 12. Radiothérapie, institut du cancer de Montpellier, 208, avenue des Apothicaires, 34298 Montpellier, France. 13. Radiothérapie, institut Jean-Godinot, 1, rue du Général-Koenig, 51100 Reims, France. 14. Radiothérapie, institut Georges-François-Leclerc, 1, rue du Professeur-Marion, 21000 Dijon, France. 15. Radiothérapie, Corad, hôpital Bretonneau, CHRU de Tours, 2 boulevard Tonnellé, 37000 Tours, France. 16. Radiothérapie, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06100 Nice, France. 17. Radiothérapie, institut de cancérologie de l'Ouest-Nantes, boulevard Jacques-Monod, 44800 Saint-Herblain, France.
Abstract
PURPOSE: Radiotherapy is a rare indication in paediatric oncology, with 800 to 900 children in treatment per year in France. Child cancers represent approximately 1% of cancers in France and half occur before the age of 5 years. Paediatric radiation requires appropriate tools, local, time and specific training. In France, in 2015, 18 centres are accredited by the French National Cancer Institute (INCa) for this activity. MATERIAL AND METHODS: Survey conducted in February 2015 on the care of children (0 to 18 years) in radiotherapy departments in France. The survey was sent to the radiation oncologists involved in the 18 centres. The questions concerned the qualitative and quantitative aspect, medical and organizational aspects, and the involvement of assistant practitioners in the management of this activity. RESULTS: Seventeen centres responded. In 2014, 889 children under 18 were treated in radiotherapy departments. These departments are working together with one to four paediatric oncology departments. Regarding access to general anaesthesia: three centres perform one to seven treatment(s) under anaesthesia per year, three centres eight to ten treatments under anaesthesia per year, three centres ten to 24 treatments under anaesthesia per year and nine centres out of 17 use hypnosis techniques. In terms of human resources, in 2015, 29 radiation therapists have a paediatric radiotherapy activity. Involvement of assistant practitioners is growing and specific training are desired. Regarding treatment preparation and delivery, 13 centres have specific paediatric contentions, 14 of 16 centres employ radiation intensity modulated if dosimetry is more satisfying with 11 regularly to the craniospinal irradiation. Radiotherapy on moving areas with respiratory gating or hypofractionation is under developed. CONCLUSION: Paediatric radiation therapy is a specific activity requiring a dedicated management, both in human, organizational, medical and scientific aspects.
PURPOSE: Radiotherapy is a rare indication in paediatric oncology, with 800 to 900 children in treatment per year in France. Childcancers represent approximately 1% of cancers in France and half occur before the age of 5 years. Paediatric radiation requires appropriate tools, local, time and specific training. In France, in 2015, 18 centres are accredited by the French National Cancer Institute (INCa) for this activity. MATERIAL AND METHODS: Survey conducted in February 2015 on the care of children (0 to 18 years) in radiotherapy departments in France. The survey was sent to the radiation oncologists involved in the 18 centres. The questions concerned the qualitative and quantitative aspect, medical and organizational aspects, and the involvement of assistant practitioners in the management of this activity. RESULTS: Seventeen centres responded. In 2014, 889 children under 18 were treated in radiotherapy departments. These departments are working together with one to four paediatric oncology departments. Regarding access to general anaesthesia: three centres perform one to seven treatment(s) under anaesthesia per year, three centres eight to ten treatments under anaesthesia per year, three centres ten to 24 treatments under anaesthesia per year and nine centres out of 17 use hypnosis techniques. In terms of human resources, in 2015, 29 radiation therapists have a paediatric radiotherapy activity. Involvement of assistant practitioners is growing and specific training are desired. Regarding treatment preparation and delivery, 13 centres have specific paediatric contentions, 14 of 16 centres employ radiation intensity modulated if dosimetry is more satisfying with 11 regularly to the craniospinal irradiation. Radiotherapy on moving areas with respiratory gating or hypofractionation is under developed. CONCLUSION: Paediatric radiation therapy is a specific activity requiring a dedicated management, both in human, organizational, medical and scientific aspects.