Measurement of the dimensions of the skull is not that easy.
Until 1973, in the Sarphatistraat in the east of Amsterdam, the Netherlands Cancer Institute (NKI) and the Emma children's hospital (EKZ) wereneighbours. Even before 1970 an intensive cooperation existed between both hospitals with respect to pediatric oncology. In 1973, when the NKI moved to the other side of town, this close cooperation remained. Every day a group of children was brought to the NKI under special guidance. This situation ended in 1985 when the EKZ moved to a department in the new teaching hospital AMC in Amsterdam South-East.
Pediatric oncologist Tom Voûte of the EKZ, radiation oncologists Marion Burgers and Bart van Bunningen of the NKI, nurses, radiation therapists and the psychosocial staff of both hospitals paid a lot of attention to the guidance of these children. At the Radiotherapy Department no stone was left unturned to obtain their confidence and to make them feel at ease.
The treatment was first played with their puppets and cuddly toys before the actual treatment started. 1969, drawing Emile van Slooten (surgeon NKI)
The children rode their bicycles into the treatment room and during the treatment their mother read stories to them through the intercom.
Radiation therapists and accompanying personnel from the EKZ play with the children and create a close relationship with them.
A playground was created for the children , with lots of daylight and separated from the waiting room for adult patients. In the summer a small swimming pool was sometimes placed there and in the winter time the children could play in a sandbox.
Childrens fixation masks. For many treatments it was necessary to use a fixation mask. In order to make the child familiar with the preparation and delivery of the irradiation it was customary to first perform all actions on a puppet.
Many children underwent a total brain irradiation because the generally applied chemotherapy compound at that time (methotrexaat) was unable to penetrate the brain-blood barrier. In this way the treatment of leukemia became more effective.
Also the small brain and the spinal cord were irradiated in the case of a medulloblastoma. The child lies in prone position with its head in a fixation mask.
These types of irradiation techniques are now obsolete due to the growing knowledge of the negative late effects on the development of the child.