With advances in multimodality therapy, childhood cancer cure rates approach 80%. However, both radiotherapy and chemotherapy may cause debilitating or even fatal “late effects” that are critical to understand, mitigate, or prevent.  QUANTEC (Quantitative Analysis of Normal Tissue Effects in the Clinic) pointed out the uncertainties relating to chronic adverse effects of adult treatments, but the situation is more complicated for children in whom a mosaic of tissues develops at different rates and temporal sequences. Childhood cancer survivors have long life expectancy and may develop treatment-induced secondary cancers and severe organ/tissue injury long after treatment.  Collaborative long-term observational studies and clinical research programs for survivors of pediatric and adolescent cancer provide some dose response data for follow-up periods exceeding 40 years.  Data analysis is challenging due to the influence of both therapeutic and developmental variables. PENTEC (Pediatric Normal Tissue Effects in the Clinic) is a group of physicians, physicists and epidemiologists conducting a critical synthesis of existing literature aiming to:

  1. Develop quantitative evidence based dose/volume guidelines to inform treatment planning and improve outcomes for survivors of radiation therapy for childhood cancers,

  2. Describe relevant physics issues specific to pediatric radiotherapy, and

  3. Propose dose-volume-outcome reporting standards to systematically inform future treatment guidelines. 

The following link will take you to the “adult" effort, (IJROBP vol 76, #3 Sep, 2010): http://www.sciencedirect.com/science/journal/03603016/76/3/supp/S 

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