The radiotherapy service for children & young people at University College London Hospitals, London, UK

Posted by Mark Gaze | June 02, 2025 - 12:10

Paediatric oncology care in the UK is divided between a limited number of regional Principal Treatment Centres (PTC) in large teaching hospital settings, and a greater number of Paediatric Oncology Shared Care Units (POSCU) typically in district general hospitals. The PTC delivers the most specialised aspects of diagnosis, treatment and oncological decision-making, and may be remote from the patient’s home; whereas the POSCU is more conveniently located for easy access and mostly provides supportive care such as blood tests and transfusions, treatment of intercurrent infections, and simple chemotherapy under guidance from PTC staff.

University College London Hospitals (UCLH) NHS Foundation Trust is comprised of a cluster of hospitals in central London, providing acute general and specialist services for patients of all ages. With the neighbouring Great Ormond Street Hospital (GOSH) for Children NHS Foundation Trust, which provides only highly specialist paediatric care, UCLH forms the PTC for cancer in children and young people across much of London and the adjacent counties to the East and North. While the age cut off varies to some extent between different specialties, for the most part GOSH focuses on those aged 12 years and under, while UCLH works with teenagers from 13 years, young adults, and older patients. Radiotherapy for all ages, however, is delivered only at UCLH, although clinical oncology staff work across both sites for multidisciplinary team (MDT) meetings and outpatient clinics.

In addition to providing radiotherapy for patients whose oncological treatment started at GOSH or UCLH, all patients from the PTC in Southampton and Oxford are treated here, as paediatric radiotherapy is not available locally. The patients aged under 16 currently treated at The Royal Marsden Hospital in Surrey will from next year, 2026, also be treated at UCLH, as the paediatric oncology service there is relocating to the Evelina Hospital in Central London.

Since 2021, UCLH has been one of the two UK proton beam radiotherapy (PBT) centres, the other is in Manchester. UCLH therefore treats patients requiring PBT from the whole of southern England and South Wales. In addition, we provide a four nations service for paediatric brachytherapy and molecular radiotherapy. Some international patients are also treated. This large and extended referral base makes UCLH by far the biggest radiotherapy service for children and young people in the UK.

This practice requires a large, dedicated paediatric multiprofessional team. We have five consultant clinical oncologists who each have pretty much an exclusive paediatric practice. We are supported by a number of junior doctors, paediatric radiotherapy play specialists, an exceptional anaesthetic team, radiotherapy physics clinical scientists and dosimetrists, therapeutic radiographers, and paediatric oncology doctors and nurses. In addition, we could not care adequately for this patient cohort without a broad range of allied health professionals including dieticians, speech and language specialists, physiotherapists, occupational therapists and a psychology team.

As so many patients travel from far away, we have a range of accommodation options for families, and we spend much time attending remote MDT meetings, and liaising with colleagues in other PTC to ensure optimal care for our patients.

As radiotherapy is about a balance between achieving effective cancer treatment while minimising the adverse consequences, we have an interest in late effects management, and recording of outcomes.

Staff members in different professional groups are involved in a broad range of national and international research, clinical trial, and radiotherapy quality assurance groups, including EpSSG; SIOPEN; Euro Ewings consortium; SIOPE brain tumour group; SIOPE Radiation Oncology Working Group; PROS and QUARTET. Wherever possible, patients are offered entry into appropriate clinical trials, with the aim of strengthening the evidence base for the future.

We are fortunate to have all radiotherapeutic modalities available, up-to-date equipment, and excellent colleagues who are each focused on delivering the best treatment for every patient. We try to be a beacon of good practice, and improve care in the wider world through our educational activities.