Harmonica consensus, controversies, and future directions in radiotherapy for pediatric Wilms tumors
McAleer, M. F. Melchior, P. Parkes, J. Pater, L. Rübe, C. Saunders, Daniel Paulino, A. C. Janssens, G. O. Kalapurakal, J.
McAleer, M. F.
Melchior, P.
Parkes, J.
Pater, L.
Rübe, C.
Saunders, Daniel
Paulino, A. C.
Janssens, G. O.
Kalapurakal, J.
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Abstract
Radiotherapy (RT) is essential for multimodality treatment of pediatric renal tumors, particularly in higher-risk and metastatic disease. Despite decades of use, particularly for Wilms tumor, there remain controversies regarding RT indications, timing, dose, and targets. To align global management, we address these issues in this international HARMONIsation and CollAboration (HARMONICA) project. There are multiple knowledge gaps and opportunities for future research including: (1) utilization of advanced RT technologies, including intensity-modulated RT, proton beam therapy, combined with image-guided RT to reduce target volumes; (2) impact of molecular biomarkers including loss of heterozygosity at 1p, 16q, and 1q gain on RT indications; (3) mitigation of reproductive toxicity following RT; (4) promotion of RT late effects research; and (5) support to overcome challenges in RT utilization in low- and middle-income countries where 90% of the world's children reside. Here, we outline current status and future directions for RT in pediatric renal tumors.
Description
Date
2022
Publisher
Collections
Keywords
Type
Article
Citation
McAleer MF, Melchior P, Parkes J, Pater L, Rübe C, Saunders D, et al. Harmonica consensus, controversies, and future directions in radiotherapy for pediatric Wilms tumors. Pediatric blood & cancer. 2022 Dec 8:e30090. PubMed PMID: 36482883. Epub 2022/12/10. eng.