The need for consensus on delineation and dose constraints of dentofacial structures in paediatric radiotherapy: outcomes of a SIOP Europe survey

Background and PurposeChildren receiving radiotherapy for head-and-neck tumours often experience severe dentofacial side effects. Despite this, recommendations contouring dose constraints to structures are lacking in clinical practice. We report on a survey aiming understand current practice assessment structures.MethodsA digital was distributed European Society Paediatric Oncology members of the Radiation Working Group, member-affiliated centres Europe, Australia, New Zealand. The questions focused aimed establish areas future development.ResultsResults from 52 paediatric across 27 countries reported. Only 29/52 routinely delineated some structures, with most common being mandible (25 centres), temporo-mandibular joint (22), dentition (13), orbit (10) maxillary bone (eight). For bones contoured, an ‘As Low As Reasonably Achievable’ objective implemented. four reported age-adapted constraints.The largest barrier implementation firstly, lack guidance (49/52, 94%) secondly, that delineation is time-consuming (33/52, 63%). Most respondents who contour (25/27, 90%) agreed atlas would aid delineation.ConclusionRoutine infrequent radiotherapy. Based findings, we aim 1) define consensus-contouring 2) develop auto-contouring solutions implementation, 3) carry out treatment planning studies investigate importance these optimisation.