Second re-irradiation: A narrative review of the available clinical data

Carsten Nieder, Johannes A Langendijk, Matthias Guckenberger, Anca L Grosu

OnderzoeksoutputAcademicpeer review

11 Citaten (Scopus)
40 Downloads (Pure)

Samenvatting

BACKGROUND: Considerable controversy exists about the safety and efficacy of second re-irradiations (three courses of radiotherapy to overlapping volumes). Therefore, all published clinical studies were reviewed.

MATERIAL AND METHODS: Contemporary and historical articles were identified. Outcomes such as survival, local control, symptom improvement and side effects were extracted. Contemporary results were grouped by anatomical location of the re-irradiated region in the body.

RESULTS: Most data were derived from central nervous system tumors, pelvic tumors and bone metastases. We could include nine contemporary, retrospective studies with 2-25 patients each. Nearly, all patients were treated with palliative intent. Most of the prescribed re-irradiation regimens were highly individualized and thus difficult to compare. Symptomatic responses were recorded in most patients. In palliatively treated patients with pelvic and bony target volumes, high-grade toxicity was uncommon.

CONCLUSIONS: Despite of issues related to study size, length of follow-up and calculation of lifetime cumulative equivalent dose, the available data provide an initial framework for future studies and discussion of dose constraints. Selected dose-fractionation regimens may result in a satisfactory therapeutic ratio even after two previous courses of radiotherapy, if these were well tolerated.

Originele taal-2English
Pagina's (van-tot)305-310
Aantal pagina's6
TijdschriftACTA ONCOLOGICA
Volume57
Vroegere onlinedatum30-nov-2017
DOI's
StatusPublished - 2018

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