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Pediatrics

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Skin Care in Radiation Oncology

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Abstract

Pediatric malignancies are a highly diverse group, collectively with involvement across all anatomic compartments.

Multi-modal interventions including post-operative or definitive radiotherapy typify management of pediatric cancers such as rhabdomyosarcoma, Ewing’s sarcoma, and Wilm’s tumor. Technological advancements in radiotherapy have enabled more focal skin-sparing radiotherapy approaches in management of pediatric malignancies, and dose de-escalation in current protocols may diminish total skin dose. However, despite technological advances, skin toxicity cannot be avoided across all anatomic sub-sites.

There are significant functional and anatomical differences between adult and pediatric skin. As compared with older individuals, the skin of children may exhibit greater water absorption and water loss, less protective melanin, and thinner stratum corneum and total epidermis. As body surface area to mass ratio decreases with age, younger patients will often experience greater percentage skin radiation exposure. Pediatric treatment protocols also routinely employ neoadjuvant and concurrent chemotherapy regimens, resulting in immunosuppression and further wound-healing impairment. Moreover, there are behavioral and psychosocial considerations with pediatric patients that further complicate adherence with treatment-related wound care.

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Acknowledgment

The editors and authors thank Leanne J. Parsons, RN, MSN for her assistance with obtaining the photos for this chapter.

Author information

Authors and Affiliations

  1. Harvard Medical School, Boston, MA, USA

    Daphne Adele Haas-Kogan

  2. Department of Radiation Oncology, Brigham and Women’s Hospital/Dana-Farber Cancer Institute, Boston Children’s Hospital, Boston, Boston, MA, USA

    Daphne Adele Haas-Kogan

  3. UCSF Ron Conway Family, Gateway Medical Building, 1825 4th Street, Room M2260, Box 4001, San Francisco, CA, 94158, USA

    Steve E. Braunstein MD, PhD

  4. Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, USA

    Steve E. Braunstein MD, PhD & Florence Yuen

  5. Departments of Pediatric Hematology, Oncology, and Bone Marrow Transplant, UCSF Benioff Children’s Hospital, San Francisco, CA, USA

    Lisa Tsang

Authors
  1. Daphne Adele Haas-Kogan
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  2. Steve E. Braunstein MD, PhD
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  3. Florence Yuen
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  4. Lisa Tsang
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Corresponding author

Correspondence to Steve E. Braunstein MD, PhD .

Editor information

Editors and Affiliations

  1. Department of Radiation Oncology, University of California San Francisco, San Francisco, California, USA

    Barbara Fowble

  2. Department of Radiation Oncology, University of California San Francisco, San Francisco, California, USA

    Sue S. Yom

  3. Department of Radiation Oncology, University of California San Francisco, San Francisco, California, USA

    Florence Yuen

  4. Department of Dermatology, University of California San Francisco, San Francisco, California, USA

    Sarah Arron

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© 2016 Springer International Publishing Switzerland

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Haas-Kogan, D.A., Braunstein, S.E., Yuen, F., Tsang, L. (2016). Pediatrics. In: Fowble, B., Yom, S., Yuen, F., Arron, S. (eds) Skin Care in Radiation Oncology. Springer, Cham. https://doi.org/10.1007/978-3-319-31460-0_12

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  • DOI: https://doi.org/10.1007/978-3-319-31460-0_12

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-31458-7

  • Online ISBN: 978-3-319-31460-0

  • eBook Packages: MedicineMedicine (R0)

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