Carsten Nieder1,2, Johannes A Langendijk3, Matthias Guckenberger4, Anca L Grosu5,6. 1. a Department of Oncology and Palliative Medicine , Nordland Hospital Trust , Bodø , Norway. 2. b Department of Clinical Medicine, Faculty of Health Sciences , University of Tromsø , Tromsø , Norway. 3. c Department of Radiation Oncology , University Medical Centre Groningen , Groningen , Netherlands. 4. d Department of Radiation Oncology , University Hospital Zürich , Zürich , Switzerland. 5. e Department of Radiation Oncology , University Hospital Freiburg , Freiburg , Germany. 6. f Partner Site Freiburg , German Cancer Consortium (DKTK) , Freiburg , Germany.
Abstract
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.
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.
Authors: Amy J Xu; Leo Luo; Jonathan E Leeman; Paul B Romesser; Daniel Spielsinger; Christopher Sabol; Todd Waldenberg; Thomas Brinkman; Nadeem Riaz; Sean McBride; Julie Kang; Nancy Lee; Chiaojung Jillian Tsai Journal: Clin Transl Radiat Oncol Date: 2020-04-24
Authors: Kelly C Paradis; Charles Mayo; Dawn Owen; Daniel E Spratt; Jason Hearn; Benjamin Rosen; Rojano Kashani; Jean Moran; Daniel S Tatro; Whitney Beeler; Karen Vineberg; Dylan C Smith; Martha M Matuszak Journal: Adv Radiat Oncol Date: 2019-06-08
Authors: Agnieszka E Zając; Sylwia Kopeć; Bartłomiej Szostakowski; Mateusz J Spałek; Michał Fiedorowicz; Elżbieta Bylina; Paulina Filipowicz; Anna Szumera-Ciećkiewicz; Andrzej Tysarowski; Anna M Czarnecka; Piotr Rutkowski Journal: Cancers (Basel) Date: 2021-05-14 Impact factor: 6.639