ESTRO supports individualized reirradiation for selected recurrent brain tumors, with cumulative dose, target volume and critical structures determining feasibility.
DIR reduced estimated liver maximum dose from 123.8 to 83.2 Gy, but accuracy deteriorated markedly for bowel and stomach.
COMPPARE enrolled 2,524 patients from 51 institutions in 52 months, with Black participation reaching 16% of the cohort.
Iodine-125 seed implantation produced 90% three-month disease control, but median local progression-free survival was nine months.
Twenty-five selected patients had 96% crude local control and no grade 3 toxicity after 26 Gy in five fractions.
ESTRO recommends selective high-dose thoracic reirradiation with comprehensive staging, limited target volumes and formal cumulative dose assessment.
Temporally modulated pulsed radiotherapy achieved a median progression-free survival of 27.2 months in large, previously irradiated recurrent meningiomas.
Prospective prostate reirradiation studies reported generally acceptable toxicity, but target volumes, dose schedules and organ constraints varied substantially.
Spine proton ablative radiotherapy achieved 74% local control at one and two years, with no radiation myelopathy in a reirradiation-enriched cohort.
High-dose carbon ion re-irradiation achieved 83.1% 3-year survival with no grade 4 toxicity in recurrent pelvic sarcoma.
Dutch radiation oncologists reported substantial variation in dose, delineation, and follow-up for unresectable locally recurrent rectal cancer.
Pencil-beam scanning proton re-irradiation achieved 17.2-month median survival with 7.7% grade 3 or higher oral mucositis.
Median survival was 8.3 months after proton reirradiation, with 5.6% grade 3–4 radiation necrosis and no survival difference versus photons.
ESTRO–ASTRO guidance supports selected rectal cancer reirradiation using 30–40 Gy regimens, cumulative dose assessment, inverse planning and daily volumetric imaging.
Pencil-beam proton reirradiation for locoregional breast cancer recurrence achieved 95% three-year overall survival, with severe toxicity uncommon despite a 21% rib-fracture rate.