Introduction

Abstract

Cancer is the leading cause of death by disease past infancy among children in the Western world. In the United States in 2014, it is estimated that 15,780 children and adolescents from birth to the age of 19 years will be diagnosed with cancer and 1960 will die of the disease (Ward et al. 2014). In 1975, fewer than 50% of children diagnosed with cancer before the age of 20 years survived more than 5 years (Ries et al. 1999). Since then results have greatly improved. In 2004–2010 more than 80% of children diagnosed with cancer before age 20 years survived at least 5 years (Howlader et al. 2013, National Cancer Institute, http://www.cancer.gov). Childhood malignancies include a variety of different tumour types. Most require multidisciplinary management with a combination of local and systemic treatments to achieve optimal outcomes; for many patients, radiation therapy as local treatment is an integral component of the therapeutic strategy.