Patients with solid tumours

Author:  Dr. med. Gesche Riabowol (geb. Tallen), Editor:  Maria Yiallouros, English Translation:  Dr. med. Gesche Riabowol (geb. Tallen), Last modification: 2025/12/04 https://kinderkrebsinfo.de/doi/e211260

Most children and adolescents with malignant diseases who receive radiotherapy‎ are patients with solid tumour‎s. Among them, patients with CNS tumour‎s form the largest group, followed by patients with soft tissue‎ and bone tumours [TIM2018a‎]. Radiation therapy is also used for certain rare tumours.

Radiotherapy for CNS tumours

In addition to surgery‎, radiation therapy is the most important treatment method for children and adolescents with tumours of the central nervous system‎ (CNS). In this age group, the brain is very sensitive to radiation‎ due to the fact that tissue development is not yet complete: in addition to functional impairments of the brain, developmental disorders and intellectual disability, there is also the risk of developing a second tumour many years after treatment of the first disease has been completed [TIM2018a‎]. Therefore, the main goal of radiation in these patients is to completely destroy the tumour while avoiding damage to the developing brain tissue as much as possible.

Good to know: Over the course of the last two to three decades, medical and technical advances have made it possible to reduce the intensity of radiation and thus radiation-related long-term effects without increasing the risk of relapse.

Based on the following factors, the treating physicians decide whether or not radiation therapy is indicated for a patient with a CNS tumour‎:

• type of CNS tumour (e.g., low- or high-grade malignant glioma, medulloblastoma) [KOR2003‎] [KOR2003a‎]
• age of the patient (children under 18 months should not receive high-dose CNS radiation)
• extent of surgical tumour removal
• presence of a concomitant disease (e.g. neurofibromatosis‎) [KOR2003‎] [KOR2003a‎] [TIM2002‎]

Further information on the use and methods of radiotherapy for CNS tumours can be found in the texts on the individual diseases in the respective chapter on “Treatment - Treatment Methods“.

Radiotherapy for other solid tumours

Another important group of patients for whom radiotherapy makes a decisive contribution to treatment success are children and adolescents with solid tumour‎s outside the central nervous system. These include, for example, extracranial germ cell tumour‎s, various tumours of the soft tissue‎s (e.g. rhabdomyosarcoma‎s, certain rhabdoid tumours), bone tumours (Ewing sarcoma, osteosarcoma‎), kidney tumours (nephroblastoma‎) as well as tumours of the sympathetic nervous system‎ (neuroblastoma‎) and retinal tumours of the eye socket (retinoblastoma‎).

As with patients with CNS tumour‎s, these tumours cannot always be completely removed because of a high risk of damage to healthy tissue. For that reason, especially for solid tumours in the trunk area (chest, abdomen, back, pelvis), modern radiation techniques such as stereotactic‎ radiation therapy or particle therapy (e.g. proton therapy‎) are increasingly being used beside conventional radiotherapy.

Further information on the use and methods of radiotherapy for above-mentioned solid tumours can be found in the texts on the individual diseases in the respective chapter on “Treatment - Treatment Methods“.

Radiotherapy for rare solid tumours

In Germany, rare solid tumour‎s in children and adolescents are defined as those that are newly diagnosed in less than ten patients per year (about 5% of all children and adolescents with cancer). These diseases include tumours of the pancreas (pancreatic tumours), the salivary glands, the throat and the larynx.

Patients with pancreatic tumours rarely receive radiation‎ therapy. Children and adolescents with laryngeal or pharyngeal tumours, on the other hand, benefit from radiation if their tumour is too large for surgery‎, or if it is unfavourably located, i.e. close to vital neighbouring organs. In this case, radiation before surgery (neo-adjuvant radiotherapy), usually in combination with chemotherapy‎, can help to shrink the tumour so that it is easier for the surgeon to remove it later.

Information on the use and methods of radiotherapy for the above-mentioned rare solid tumours can also be found in the texts on the individual diseases in the respective chapter on “Treatment“.