What is the preferred radiation delivery technique for whole abdominal or flank RT in childhood cancers?

The rationale for using less sophisticated techniques to treat flank and whole abdominal fields has largely been centered on reducing the potential for growth discrepancies by treating with homogeneous doses across bony structures, most notably the spinal column and pelvic bones. The use of AP/PA fields hasn’t been viewed as a big issue when flank and whole abdominal radiotherapy fields are used because of the lower doses which are typically applied in these clinical contexts. There are select c...

Agree with all of the above @Dr. First Last - the outcomes in terms of abdominal control with traditional flank and whole abdominal fields are excellent (Ehrlich et al., PMID 23382471) with a less than 5% rate of in-abdomen recurrence. This and the low doses of RT delivered have been the primary drivers of continuing with these large volume fields of treatment. There are, unfortunately, still long term effects of RT that will develop including chronic kidney disease (Green et al., PMID 33653686)...