INTRODUCTION: Optimal management of paediatric @entity1 with @entity5 may include radiation therapy. Proton therapy, in theory, should achieve superior outcomes. For @entity1 referred overseas, multiple factors are taken into consideration. AIM AND METHODS: The purpose of this article is to provide context to current decision making. The MEDLINE, EMBASE and PubMed databases were searched for relevant literature. RESULTS AND DISCUSSION: The delivery of proton therapy is in evolution. Tissue homogeneity, movement and anatomical changes all present a greater challenge for proton therapy compared with photon therapy. Many dosimetry studies are relying on historical data for cost-benefit analyses that do not accurately reflect contemporary photon therapy. The low dose regions generally do not create significant @entity137 , whereas moderate dose regions can be reduced by different techniques such as stereotactic radiotherapy and brachytherapy. Neuro-cognitive and @entity137 are associated with the greatest health cost, so the greatest gain is for @entity5 within or abutting the central nervous system. Proton therapy does not eliminate the risk of second @entity5 . CONCLUSIONS: The benefits of proton therapy must be weighed against not just the estimated impact of low and moderate radiation doses on the developing @entity1 but the disruptions to the @entity1 , and family life. Relative contraindications to proton therapy include when the relevant late @entity137 relate to the high radiation dose region, when the @entity5 volumes encompass whole body sections and when the target is imprecise. @entity1 with base of skull @entity5 or an inherited risk of @entity5 (e.g. those with @entity876 or @entity996 genes) should be considered for proton therapy.

Defining the role of proton therapy in the optimal management of paediatric XXXX in Australia and New Zealand.

@entity1 :: ('9606', 'Species') :: ['children', 'patients', 'Children', 'child'] @entity137 :: ('MESH:D064420', 'Disease') :: ['toxicity', 'neuro-endocrine toxicities', 'toxicities'] @entity5 :: ('MESH:D009369', 'Disease') :: ['cancer', 'tumours', 'malignancy', 'tumour'] @entity996 :: ('5925', 'Gene') :: ['Rb1'] @entity876 :: ('7157', 'Gene') :: ['p53']
@entity1 :: (9606,Species) :: ['patients']
