RADIOTHERAPY IN THE TREATMENT OF CHILDREN WITH CANCER: A NARRATIVE REVIEW

Abstract

This narrative review aims to analyze the main aspects of radiotherapy in the treatment of pediatric cancer, with emphasis on side effects—particularly impaired childhood growth—and on therapeutic strategies developed to mitigate these impacts. A literature search was conducted in the PubMed, SciELO, and Google Scholar databases, including publications from 2008 to 2023. The descriptors used were “radiotherapy,” “pediatric cancer,” “side effects,” and “growth,” and studies published in Portuguese and English that addressed the application of radiotherapy in pediatric oncology, its adverse effects, and related technological advances were included. The findings show that the main side effects of radiotherapy in children include growth delay, endocrine dysfunctions, and an increased risk of secondary neoplasms. Accordingly, technological innovations such as intensity-modulated radiotherapy (IMRT), proton therapy, and image-guided radiotherapy (IGRT) have shown promise in reducing these adverse effects by allowing more precise delivery of radiation to the tumor tissue while sparing adjacent healthy structures. Furthermore, complementary strategies such as dose fractionation, conformational techniques, and the use of biomarkers have contributed to improving the safety and efficacy of treatment. Therefore, although radiotherapy remains a fundamental therapeutic modality in the management of pediatric cancer, it requires specific and ongoing attention to its adverse effects, with technological advances representing a major step toward preserving growth and quality of life in pediatric patients.