Brachytherapy for pediatric patients at Gustave Roussy Cancer Campus: A model of international cooperation for highly specialized treatments

PURPOSE: Childhood cancer is rare, and treatment is frequently associated with long-term morbidity. Disparities in survival and long-term side-effects encourage the establishment of networks to increase access to complex organ conservative strategies, such as brachytherapy (BT). We report our experience of an international cooperation model in childhood cancers. METHODS AND MATERIALS: We examined the outcome of all children referred to our center from national or international networks to be treated according to a multimodal organ-conservative approach including BT. RESULTS: 305 patients were identified; median age at diagnosis was 2.2 years (1.4 months-17.2 years). Ninety-nine (32.4%) were treated within 2015-2020. One hundred seventy-two (56.4%) were referred from national centers and 133 (43.6%) were international patients, from 31 countries (mainly Europe). Two hundred sixty three patients were referred for primary treatment and 42 for salvage treatment. Genito-urinary tumors were the most frequent sites, with 56.4% bladder/prostate rhabdomyosarcoma (RMS) and 28.5% gynecological tumors. In addition to BT, local treatment comprised partial tumor resection in 207 (67.9%) and 39 (13%) had additional external radiotherapy. Median follow-up was 58 months (range: 1 month-48 years), 93 months for national patients and 37 months for international patients (p