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Pediatric Radiation Oncology

Pediatric cancers consist of a wide variety of tumors arising in children involving nearly every organ of the body. Over 50% of the 9,800 cases of childhood cancers diagnosed each year in the United States are leukemias or brain tumors. Other pediatric cancers include Hodgkin’s lymphoma, Wilm’s tumor, Ewing’s sarcoma, rhabdomyosarcoma, neuroblastoma, and retinoblastoma. Many of these tumors are extremely uncommon.

ROA has been the primary radiation treatment center for the pediatric population in Northern Virginia for over a decade. ROA is the largest radiation oncology practice in the Washington, D.C. area. We are large enough that our doctors are specialized with expertise in particular cancer types, treatments, and even ages. Dr. Samir Kanani and Dr. Ashish Chawla lead our team of specialists who work closely with the pediatric teams at National Children’s Medical Center and Inova Fairfax Hospital for Children to provide the highest quality radiation treatment for our pediatric patients. Through participation in multidisciplinary clinics and tumor boards with pediatric oncologists, surgeons, radiologists, pathologists, and neurocognitive experts, our pediatric radiation program provides comprehensive care with consideration and input from all of the important pediatric specialties before each recommendation is made. Dr. Kanani and Dr. Chawla is a full member of the Children’s Oncology Group (COG) and we offer radiation treatment on all of their pediatric cancer protocols.

Role of Radiation Therapy in Pediatric Oncology

Radiation therapy has always maintained an important role in the treatment of childhood cancers. In the past, pediatric patients were treated with large radiation fields and relatively high doses of radiation to achieve long-term cures. Over time we have gained an appreciation of the long-term effects of radiation in the pediatric population. Today we take every step to minimize the radiation exposure of our young patients. The increasing use of chemotherapy and substantial improvements in the accuracy of radiation treatment have enabled radiation oncologists to dramatically reduce the amount of radiation necessary to cure our patients. At the same time, because of these novel approaches the long-term effects of radiation on our patients are expected to be significantly lower. At ROA, we are keenly aware of this emerging concept in pediatric oncology and carefully consider this for every patient and family we see in consultation.

Radiation Therapy Technology

A wide variety of radiotherapy techniques are currently used in childhood cancers. In some childhood cancers it is necessary to treat a large area because there is a risk for cancer involvement throughout. In this setting conventional radiation techniques are used which intentionally do not block normal tissues. A classic example of this is the central nervous system where cancer cells may have access to the entire circulation of cerebrospinal fluid that surrounds the brain and spinal cord, and this compartment must be treated in its entirety to ensure that all cancer cells are destroyed. In contrast, some cancers require high dose treatment to a small, localized target that may be located in close proximity to critical and/or sensitive normal tissues. In this case highly technical radiation delivery is indicated to deliver the needed dose to the tumor while minimizing any collateral radiation to the surrounding normal tissues. ROA is proud to offer numerous options for these patients including 3D Conformal Radiation (3DCRT), Intensity-Modulated Radiation Therapy (IMRT), Stereotactic Radiosurgery (SRS), Stereotactic Body Radiation Therapy (SBRT), Image-Guided Radiation Therapy (IGRT), Respiratory-Gated Radiation Therapy (RGRT), or some combination of these highly technical radiation treatments. In conjunction with INOVA Fairfax Hospital, ROA has acquired the prestigious Trilogy® and Tomotherapy® treatment devices, as well as the BrainLAB™ beam shaping system, for the optimal delivery of these treatment techniques. We are also very proud to offer Frameless SRS for selected patients using the Trilogy® / BrainLAB™ system. Your radiation oncologist considers the advantages of every treatment device and technique when deciding on the optimal treatment approach for each patient. Your radiation oncologist will discuss these considerations with you during your consultation. For a detailed explanation of the treatments offered please select from the list below:

  • Conventional Radiation Therapy
  • 3D Conformal Radiation Therapy
  • Intensity-Modulated Radiation Therapy
  • Stereotactic Radiosurgery (SRS) (See also Frameless SRS)
  • Stereotactic Body Radiation Therapy (SBRT)
  • Image-Guided Radiation Therapy (IGRT)
  • Respiratory-Gated Radiation Therapy (RGRT)
  • Pediatric Anesthesia

After an initial consultation with the doctor, it may be determined that your child will require anesthesia during radiation treatment. This is often the case for pediatric patients under the age of 4, but this decision is always made on an individual basis.

Our dedicated staff is highly experienced with the treatment of children under anesthesia. The Radiation Oncology Department works closely with the Department of Anesthesia to ensure that both the radiotherapy and anesthesia are administered safely and effectively.

Pediatric Oncology Team

Our Pediatric Cancer Team is comprised of dedicated professional with considerable experience in the treatment of children with cancer.

Working closely with Drs Bajaj and Kanani are their colleagues at Children’s National Medical Center and the Inova Fairfax Hospital for Children.

Our pediatric patients are treated in the Department of Radiation Oncology at INOVA Fairfax Hospital where they will interact with our wonderful oncology nursing staff, child-life specialists, and dedicated therapists. Also available in our department are on-site nutrition services and social workers.

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