Proton therapy for childhood tumours

Radiotherapy represents an important element for long-term healing in the therapy concept for childhood. It offers an important chance when the limits of operative possibilities have been reached. Unfortunately, however, because of their not yet fully developed tissue, children are particularly prone to the occurrence of radiation-related side effects and also secondary tumours.

The recovery rates with this therapy are however very high. Consequently, besides the healing of the tumour, today the quality of life following tumour therapy is also an important goal of therapy. Particularly for infantile cancer, proton therapy is a highly promising instrument, as the physical properties of the protons enable a very restricted and well controlled effect. The normal tissue is largely unaffected, and the risk of negative effects due to the therapy and of secondary tumours is reduced. The treatment is usually well tolerated and allows the continuation of life’s usual activities, such as school, sport and meeting friends.

At the WPE the therapy of children is a particular priority. At the present time, primarily brain tumours (and here in particular ependymomas, medulloblastomas, astrocytomas, cranio- pharingeomas and AT/RT), as well as sarcomatous tumours in the base of the skull, head and neck, spinal and pelvic regions (rhabdomyosarcomas, Ewing sarcomas, chordoms and chondrosarcomas) are treated. We have particular experience with the irradiation of the entire central nervous system, including the craniospinal axis.

Practical procedure

Proton therapy takes place as with adults mostly five times per week over a period of around four to seven weeks. Treating children as patients of course required considerable care and attention. Before therapy, the parents and/or the child speak with the radiotherapist and, if necessary, also with the anaesthesiologist about the overall procedure, as well as the chances and possible risks of the therapy. Furthermore, the WPE offers psychological support for the young patients and their families over the entire time of therapy with the objective of dispelling fears before beginning the procedure, preparing the children for proton irradiation according to their age, accompanying them and providing strength to the family as a whole.

Here it can be decided what can ease the daily sessions for the child: music CDs, cuddly animals, or the voice of mama or papa via the microphone.

Therapy under anaesthesia

It is equally important with children that they lie still during the therapy. With very young children this is often not possible. This is mostly the case with children under the age of five years, as they do not entirely understand the reason for and the risks entailed with the therapy. The planning and therapy must then take place under anaesthesia or deep sedation with spontaneous breathing – similar to an MRT examination in this age. This deep sedation is performed by an experienced paediatric anaesthetist. As a rule, an intubation and artificial respiration are not necessary. Regardless of the age, time, patience and understanding are often required to repeatedly obtain the help of the little patients and to positively prepare them to face the situation. Here, we support the families with all our knowledge and experience.

Here it can be decided what can ease the daily sessions for the child: music CDs, cuddly animals, or the voice of mama or papa via the microphone.

Collaboration with other institutions

Patients often come to us from great distances. Children are of course accompanied by another person or other persons. This frequently makes hotel accommodation necessary, as well as paediatric care (often including chemotherapy) or, with young children, daily sedation which must be prepared. In order to comply with these considerations, our team collaborates closely with the Paediatric Clinic (the Paediatric Clinic III is one of the first centres of the German Cancer Society (DKG) to be awarded the title “Certified Paediatric Oncological Centre”), the Parents’ House of the Essen Parents Association, and other departments of the University Hospital Essen.

Here it can be decided what can ease the daily sessions for the child: music CDs, cuddly animals, or the voice of mama or papa via the microphone.

Incidentally: Of course we also reward so much patience on the part of our small patients: Following each therapy session the children receive a pearl – at the end of the entire therapy series, they then have a lovely pearl necklace which they can take home.