Complex Clinical Decision-Making Process of Re-Irradiation
- PMID: 32893056
- DOI: 10.1016/j.clon.2020.07.023
Complex Clinical Decision-Making Process of Re-Irradiation
Abstract
As patients live longer with their cancer as a result of more effective treatment, recurrences and second malignancies in a previously irradiated field are an increasing challenge. The technical advances that enable high-dose radiation to limited volumes, excluding critical normal tissues, have increased the use of re-irradiation for many tumour sites. Minimising the volume, selecting patients with good performance status, negative metastatic screening and longer disease-free intervals are important principles. Despite this there is a narrow therapeutic window, and careful consideration with open discussion, including the patient, of the probable benefit and the implications of potential toxicities will always be essential. In this overview we evaluate the various radiobiological factors that need to be considered for re-irradiation, tissue recovery and dose tolerances in the setting of re-irradiation and summarise the available literature to guide clinicians in their decision-making for re-irradiation to primary and metastatic site/s of disease.
Keywords: Normal tissue recovery; re-irradiation; re-irradiation normal tissue tolerance; retreatment.
Copyright © 2020 The Royal College of Radiologists. All rights reserved.
Comment in
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Re-irradiation of the Breast for Angiosarcoma.Clin Oncol (R Coll Radiol). 2021 Mar;33(3):e200. doi: 10.1016/j.clon.2020.12.015. Epub 2021 Jan 11. Clin Oncol (R Coll Radiol). 2021. PMID: 33446388 No abstract available.
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