Preparation for radiotherapy

Author:  Dr. med. habil. Gesche Tallen, Ingrid Grüneberg, English Translation:  Dr. med. Gesche Riabowol (geb. Tallen), Last modification: 2025/11/26 https://kinderkrebsinfo.de/doi/e211417

Prior to the first radiation‎ session, patients and families will be educated about this form of treatment by the radiation therapists and the treatment team on the oncology ward. The team includes medical-technical radiology assistants (MTRAs).

In these meetings, patients and relatives learn details about the procedure of radiation and what preparations are necessary (see next chapter "Positioning"). In addition, there are specialists from the psychosocial and nursing teams, who will also provide support and advice.

Good to know: The treatment team (radiation therapists, medical-technical radiology assistants, nurses, psychologically trained specialists) supports patients and relatives in a professional way. For example, the information about the upcoming radiation will be communicated age-appropriately.

The procedures described below have proven to be helpful in order for patients (and also parents and relatives) to be able to prepare and get involved in radiation and to avoid major fears.

Preparations for younger children (toddlers and children of primary school age)

  • The radiation therapists or radiology assistants (MTRAs) explain each step in a child-friendly way and involve the parents. It is important to plan enough time so that there is no pressure.
  • Toddlers are usually irradiated under anaesthesia‎.
  • No anaesthesia is necessary at the earliest for children from the age of 4-5 years who remain laying still. However, this always depends on how the child reacts to the situation. There are also much older children who cannot lie still and therefore can receive anaesthesia as well.
  • Families are given the opportunity to visit the irradiation room and the so-called "irradiation table" beforehand, if they like.
  • If a mask for the face has to be made: The radiation mask may be painted, possibly a test mask may also be created and put on. How does that feel?
  • The favourite cuddly toy also receives a mask and is allowed to "try it out".
  • The "practice" of the irradiation in its details: darkening, lying quietly, perhaps with a stopwatch, cleaning up together afterwards, i.e. lowering the irradiation table, hanging the mask in its place.
  • The "saying goodbye" in the radiation room is practiced when everyone has to go out.
  • The parents pack a bag for the "excursion" to the irradiation (for example with a drink, a small meal, a game and a book for waiting times).
  • After irradiation, there may be a reward, perhaps a pearl for a necklace.
  • Child-friendly literature is available in many local clinics or can be ordered.

Preparations for older children (from 10–12 years) and adolescents

  • The treatment team explains the course of treatment in an age-appropriate way and addresses questions from older children and adolescents.
  • The children and adolescents receive age-appropriate information material (for example, the information sheets, books and videos provided by the treatment team, as well as corresponding online information).
  • Contact with other young people who have already had the experience of radiation therapy or with families whose child has already received radiation therapy. Contact with self-help groups.

Preparations for all ages

  • Avoiding expressions of fear coming from the parents (for example, that the child/adolescent might not lie still)
  • No pressure – for example, do not be strict, do not "beg" and do not threaten punishment if a child or adolescent does not lie still during radiation. This is not a catastrophe, and if there is no other way, then in the future the patient can receive a sedative before radiation or a new attempt can be started the next day. Medically, it is not a problem if the radiation is subsequently delayed a little.
  • Discuss the "how" ("Should a cuddly toy come along?"; "Which book would you like to read in the waiting room?", "What do we do afterwards as a reward?")
  • Test irradiation: In many treatment centres, a "test irradiation" takes place in the time between the family meeting and the final assessment of the radiation field (both on the ward and in the radiation clinic), in which the course of an irradiation is simulated. The pace depends on the patient's needs and cooperation.