{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T14:32:38Z","timestamp":1782743558098,"version":"3.54.5"},"reference-count":18,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2017,7,11]],"date-time":"2017-07-11T00:00:00Z","timestamp":1499731200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100002669","name":"Elekta","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002669","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background\/Objectives<\/jats:title><jats:p>The practice of palliative radiation therapy (RT) is based on extrapolation from adult literature. We evaluated patterns of pediatric palliative RT to describe regimens used to identify opportunity for future pediatric\u2010specific clinical trials.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design\/Methods<\/jats:title><jats:p>Six international institutions with pediatric expertise completed a 122\u2010item survey evaluating patterns of palliative RT for patients \u226421 years old from 2010 to 2015. Two institutions use proton RT. Palliative RT was defined as treatment with the goal of symptom control or prevention of immediate life\u2010threatening progression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 3,225 pediatric patients, 365 (11%) were treated with palliative intent to a total of 427 disease sites. Anesthesia was required in 10% of patients. Treatment was delivered to metastatic disease in 54% of patients. Histologies included neuroblastoma (30%), osteosarcoma (18%), leukemia\/lymphoma (12%), rhabdomyosarcoma (12%), medulloblastoma\/ependymoma (12%), Ewing sarcoma (8%), and other (8%). Indications included pain (43%), intracranial symptoms (23%), respiratory compromise (14%), cord compression (8%), and abdominal distention (6%). Sites included nonspine bone (35%), brain (16% primary tumors, 6% metastases), abdomen\/pelvis (15%), spine (12%), head\/neck (9%), and lung\/mediastinum (5%). Re\u2010irradiation comprised 16% of cases. Techniques employed three\u2010dimensional conformal RT (41%), intensity\u2010modulated RT (23%), conventional RT (26%), stereotactic body RT (6%), protons (1%), electrons (1%), and other (2%). The most common physician\u2010reported barrier to consideration of palliative RT was the concern about treatment toxicity (83%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There is significant diversity of practice in pediatric palliative RT. Combined with ongoing research characterizing treatment response and toxicity, these data will inform the design of forthcoming clinical trials to establish effective regimens and minimize treatment toxicity for this patient population.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.26589","type":"journal-article","created":{"date-parts":[[2017,7,11]],"date-time":"2017-07-11T12:17:45Z","timestamp":1499775465000},"source":"Crossref","is-referenced-by-count":29,"title":["Practice patterns of palliative radiation therapy in pediatric oncology patients in an international pediatric research consortium"],"prefix":"10.1002","volume":"64","author":[{"given":"Avani Dholakia","family":"Rao","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology and Molecular Radiation Sciences Johns Hopkins School of Medicine  Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinyu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology and Molecular Radiation Sciences Johns Hopkins School of Medicine  Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7514-0943","authenticated-orcid":false,"given":"Ralph P.","family":"Ermoian","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Washington  Seattle WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara R.","family":"Alcorn","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology and Molecular Radiation Sciences Johns Hopkins School of Medicine  Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Luisa S.","family":"Figueiredo","sequence":"additional","affiliation":[{"name":"Department of Radiation Grupo de Apoio ao Adolescente e \u00e0 Crian\u00e7a com C\u00e2ncer  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiation Grupo de Apoio ao Adolescente e \u00e0 Crian\u00e7a com C\u00e2ncer  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Dieckmann","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Universit\u00e4t Klinik F\u00fcr Strahlentherapie und Strahlenbiologie  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon M.","family":"MacDonald","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Massachusetts General Hospital  Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew M.","family":"Ladra","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology and Molecular Radiation Sciences Johns Hopkins School of Medicine  Baltimore 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