Radiation Therapy for Pediatric Cancers: Precision Techniques, Late Effects, and Survivorship Strategies

Dear Colleagues,

The landscape of pediatric radiation oncology is undergoing a transformative shift, moving from uniform treatment protocols to molecularly-driven precision medicine. As five-year survival rates now exceed 85%, the clinical focus has expanded beyond mere cure to the lifelong preservation of function.

Radiation therapy plays a critical role in the management of pediatric cancers, where the goals extend beyond tumor control to include the preservation of normal tissue function and the minimization of long-term complications. The potential for late effects, ranging from growth abnormalities and neurocognitive impairment to secondary malignancies, remains a central concern in treatment planning and delivery. As survival rates continue to improve, increasing attention has been directed toward optimizing therapeutic strategies that balance efficacy with long-term quality of life.

Recent advances in radiation therapy are transforming the landscape of pediatric oncology. Technologies such as intensity-modulated radiation therapy (IMRT), volumetric modulated arc therapy (VMAT), proton therapy, and boron neutron capture therapy (BNCT) have improved treatment outcomes. Adaptive radiation therapy strategies further enhance treatment accuracy, particularly for patients with tumor response, post-operative edema, or weight change. These innovations are contributing to safer and more individualized treatment approaches for pediatric patients.

At the same time, a growing body of research is focused on understanding, monitoring, and mitigating late effects associated with radiation exposure. Efforts in survivorship research have led to improved risk modeling, long-term follow-up protocols, and multidisciplinary care strategies that address the physical, cognitive, and psychosocial needs of survivors. The integration of advanced imaging, biomarkers, and data-driven approaches, including artificial intelligence and machine learning, is expected to further refine risk prediction and guide personalized treatment decisions.

This Special Issue, titled “Radiation Therapy for Pediatric Cancers: Precision Techniques, Late Effects, and Survivorship Strategies”, invites contributions from clinicians, physicists, and researchers to present the recent cutting-edge research in molecularly defined risk-stratified treatment approaches and the integration of targeted biological agents that minimize the "collateral damage" to developing tissues.

We invite original research, systematic reviews, and clinical perspectives that address the intersection of advanced physics and tumor biology. Topics of interest include, but are not limited to, advances in treatment planning and delivery, clinical outcomes, late toxicity assessment, survivorship care models, and emerging technologies for pediatric cancer therapy. By examining late effects on the cardiovascular, neurocognitive, and endocrine systems within modern survivorship frameworks, this collection aims to support the development of safer and more effective care for childhood cancer survivors and to promote collaboration in this field.

Dr. John T. Lucas, Jr.
Dr. Chincheng Chen
Guest Editors

Manuscript Submission Information

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