**9. Mitigation strategies and surveillance guidelines**

The avoidance of lung RT in children with good response to chemotherapy and lack of adverse biomarkers can significantly reduce the risks for pulmonary toxicity. Modern protocols with IMRT in COG use lower doses of RT (12Gy) with lung heterogeneity compared to SIOP protocols.

The COG LTFU guidelines, version 5.0, provide extensive recommendations for the appropriate surveillance of childhood cancer survivors for common RT-induced toxicities observed in WT survivors (http://survivorshipguidelines.org). A summary of these guidelines is provided in **Table 3**.
