Proton radiotherapy has promised an advantage in safely treating pediatric malignancies with an increased capability to spare normal tissues, reducing the risk of both acute and late toxicity. The past decade has seen the proliferation of more than 30 proton facilities in the United States, with increased capacity to provide access to approximately 3,000 children per year who will require radiotherapy for their disease. We provide a review of the initial efforts to describe outcomes after proton therapy across the common pediatric disease sites. We discuss the main attempts to assess comparative efficacy between proton and photon radiotherapy concerning toxicity. We also discuss recent efforts of multi-institutional registries aimed at accelerating research to better define the optimal treatment paradigm for children requiring radiotherapy for cure.

中文翻译：

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质子治疗在小儿恶性肿瘤中的作用：最新进展和未来方向。

质子放疗有望在安全治疗小儿恶性肿瘤方面具有优势，可以增加保留正常组织的能力，从而降低急性和晚期毒性的风险。在过去的十年中，美国30多个质子设施激增，每年为大约3,000名需要接受放射疗法治疗其疾病的儿童提供服务的能力有所提高。我们对描述普通质子疾病部位质子治疗后的结局的初步努力进行了回顾。我们讨论了评估毒性的质子和光子放射疗法之间比较疗效的主要尝试。