What happens during radiotherapy?
Meet Jake who can tell you all about radiotherapy for children.
When your child is diagnosed with a brain tumour, they may be given radiotherapy as a treatment. This uses controlled and targeted doses of high energy beams of charged particles to destroy the tumour cells, whilst causing as little damage as possible to surrounding healthy cells.
Not all children diagnosed with a brain tumour will be able to receive radiotherapy as a treatment option.
There are two main reason why your child may be given radiotherapy:
The decision to give radiotherapy will be based on a number of factors:
If your child is under three years old, it is unlikely that they will be given radiotherapy. Radiotherapy can be damaging to very young children, having a long-term impact on cognition, growth and hormone levels. However, some tumour types e.g. ependymoma, may be treated with radiotherapy in younger children, if the tumour is in the posterior fossa (the back of the skull).
At all times the type and dose of radiation needed for treatment will be taken into account and the benefits of treatment will be weighed against any immediate or long-term risks. Radiotherapy is only offered if there are no other, equally successful treatments available to your child.
Before your child is given radiotherapy treatment, a lot of planning and preparation is needed. This is to make sure the treatment is as effective as possible whilst minimising the side-effects.
To help prepare your child for radiotherapy, The Brain Tumour Charity has produced an animation to explain the treatment, including the noise a radiotherapy machine makes.
Other tips and help on how to prepare your child for radiotherapy and its possible side-effects can be found in the fact sheet at the bottom of this page.
Your child's radiotherapy treatment is very carefully planned by a team of medical specialists to ensure that it reaches as many tumour cells as possible, whilst avoiding as much healthy tissue as possible.
First a 'radiotherapy planning scan' will be taken. This is usually a CT scan, but sometimes an MRI scan. The scan creates a 3D image of your child's tumour, showing its shape and location in the brain. This image and measurements from the scan allow more precise planning of where the radiotherapy needs to be targeted, the dose required and how often it needs to be given.
It is important that your child lies very still during treatment, so that the radiotherapy is directed to the correct part of the brain. To help your child stay still, a treatment mask is made specifically to fit your child's face and head. This mask fixes to the treatment couch to keep their head still and in the same place each time they have treatment.
There are different types of masks, made from different materials. They are made by smoothing the warmed material onto your child's face, so that the final mask is an exact replication of the size and shape of their head. Gaps are left for the eyes, nose and mouth, so your child is always able to breathe easily.
A play therapist may work with your child to make wearing the mask less daunting.
Thermoplastic radiotherapy mask being made (there are other types of masks).
Images reproduced with the kind permission of
Cambridge University Hospitals NHS Foundation Trust.
Your child's treatment is planned to suit their individual needs, so may be very different to the treatment of other children you may meet.
If your child is very young or extremely anxious and won't keep still, a short general anaesthetic may be given. Or a health play specialist may work with your child to keep them calm and still.
Treatment times will vary, depending on your child's individual treatment plan.
However, each treatment session (fraction) generally only lasts a few minutes. The treatment appointment will be considerably longer, due to the time taken to position your child in the correct place. If you child is having radiotherapy to their spine, this can also take longer.
A typical radiotherapy plan is once a day, Monday to Friday, with a break at the weekends.
It is common for your child to have radiotherapy for 4 to 6 weeks.
Your child's health team can tell you your child's exact treatment plan.
If your child is having radiotherapy as an outpatient, they will be able to go home after each session. If they need to remain in hospital for another treatment, a nurse will take them back to their ward.
Your child will NOT be radioactive after treatment. It is safe for them to be around people, including other children.
After the whole course of treatment, your child will have regular check-ups to monitor the effects of the radiotherapy on the tumour and any side-effects you child may get.
These will partly depend on the area of the brain where the radiotherapy is directed, and what that area controls. Also radiotherapy works best on rapidly dividing cells, such as tumour cells, but some normal cells in the treatment area also divide rapidly, so these areas tend to have the most common side-effects. These include hair and skin cells.
For more information about these side-effects and how to cope with them, download the full factsheet at the bottom of this page.
Unfortunately, because a child's central nervous system is still developing, radiotherapy can cause some long-term or delayed/late effects. These will depend on which areas of the brain have been included in the treatment area, but can include effects on:
Other possible long-term side-effects include: cataracts, heart conditions, developing a second tumour.
For more information on these long-term side-effects, download the fact sheet at the bottom of this page.
Your child's health team will talk through any side-effects with you before treatment, and can help you with any effects your child develops.
Proton Beam Therapy (PBT) is a specialised type of radiotherapy that is suitable for some types of brain tumour and is thought to cause fewer long-term side-effects. Facilities to provide PBT in the UK, on the NHS and privately, should be available in 2018.
Page last reviewed: 02/2018
Next review due: 02/2021
Find out more about Radiotherapy for children in the full fact sheet - including more information about the longer-term effects and on resources to deal with hair loss.
Find out more about Radiotherapy for children in the full fact sheet - Clear print version, designed to RNIB guidelines.
Includes more information about the longer-term effects and on resources to deal with hair loss.
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