Re-irradiation

Questions discussed in this category

How would you manage a recurrent cervical cancer previously treated with vaginal cuff brachytherapy and has had a complete response to chemo-immunotherapy?

The 4 cm cuff recurrence occurred 3 years after definitive treatment with hysterectomy and vaginal cuff brachytherapy to 21 Gy. The recurrence had a c...

3 Answers available

What cumulative dose constraints would you use for the normal liver when repeating SBRT for liver metastases with a longer time interval (i.e. 2-3 years)?

Do you factor in the time interval when deciding cumulative dose constraints?

1 Answer available

Is there a role for re-irradiation of a recurrent keloid?

Does the time interval between the intial RT and recurrence influence your decision? What time interval would you feel is appropriate? What dose would...

2 Answers available

How would you manage a patient who received pelvic radiation 15 years ago and now has a 5 cm colon adenocarcinoma and squamous cell carcinoma of the anorectum?

What special considerations or precautions would you keep in mind when considering re-irradiation? The prior radiation was post prostatectomy RT. ...

1 Answer available

What dose/fractionation would you offer a non-operable patient with a low-lying T2N0 rectal cancer in the setting of prior pelvic radiation >10 years ago?

If records have been destroyed, how do you factor prior pelvic radiation for prostate cancer into your decision?

1 Answer available

How do you approach small bowel constraints in the setting of reirradiation?

Do you assume some recovery since the prior course of RT? If so, how much over what time period?

2 Answers available

How do you modify your dose constraints when giving lung SBRT to a new lesion in a patient previously treated with lung SBRT?

How does your approach change for same lung but now a different lobe v. different lung? How do you adjust your constraints?

1 Answer available

What dose and fractionation do you use in the setting of head and neck reirradiation?

Does your recommendation change depending on the disease-free interval?

6 Answers available

Do you recommend treatment of the entire extent of the hardware and/or bone when treating a bone metastasis that has received pre-irradiation surgical stabilization?

For example, would you treat the entire length of the femur after prophylactic intramedullary rod fixation for a femoral neck metastasis?

2 Answers available

If a patient has a history of lumpectomy and adjuvant radiation, and then develops an in-breast recurrence s/p mastectomy with breast only disease and no nodal disease, would you re-irradiate the chest wall?

Would you include the regional nodes?

2 Answers available

What is your approach to brain reirradiation in the setting of recurrent/progressive gliomas?

If a WHO II glioma was treated with RT and recurs and is now a WHO III glioma would you retreat with radiation? What would be your target volume...

2 Answers available

How are you approaching head and neck re-irradiation cases if the recurrent cancer has been resected but with high risk features such as ECE etc.?

Can you comment on fractionation schedules with and without chemotherapy or immunotherapy.

1 Answer available

What is your treatment approach for re-irradiation of a pituitary adenoma?

What dose fractionation and volume do you use? What factors influence your decision?

1 Answer available

When using concurrent hyperthermia with reirradiation, is there any benefit to delivering hyperthermia on non-RT days?

Is there any further benefit of hyperthermia monotherapy, for example, continuation of hyperthermia after the course of radiation has completed?

1 Answer available

Do you treat radiation-induced sarcomas similarly to de novo sarcomas?

How does grade, margin status, and previous radiation dose factor into the recommendation?

1 Answer available

What is your approach when it comes to reirradiation for DIPG patients who have already received 54Gy upfront?

1 Answer available

For a recurrent medulloblastoma in the posterior fossa several years after initial standard risk therapy (23.4 Gy CSI), and in which the patient is still less than 18, how would you approach re-irradiation?

Assuming CSF is negative for neoplastic cells would you: Re-irradiate gross disease only? Re-irradiate posterior fossa only? Re-irradiate the entir...

2 Answers available

How do you decide between re-irradiation, chemotherapy, and alternating electric field therapy in patients with relapsed GBM post chemoradiation with TMZ?

If choosing systemic therapy, do you prefer bevacizumab with or without irinotecan? Have you used anti-PD1 agents (e.g. nivolumab) off label?

1 Answer available

Do you re-irradiate for heterotopic ossification in patients who re-develop ossifications?

If the patient had RT 3 months prior and had a revision surgery, would you offer RT again? If so, which dose and fractionation would you use?

1 Answer available

What is the appropriate volume to re-irradiate in a recurrent GBM?

If a patient has increasing FLAIR and T1 enhancing activity, should both be included in the treatment volume? What factors to you consider in making y...

1 Answer available

What factors would make you strongly consider re-irradiation of the chest wall in a patient who has previously undergone whole breast irradiation?

1 Answer available

What is the optimal/safest regimen for re-irradiation of a partial chest wall following surgical resection of an isolated chest wall recurrence?

Is there any literature supporting that a gentle fractionation/bid regimen (i.e., 1.5Gy bid x 30 = 45Gy) is safer than a standard fractionation ...

4 Answers available

Is it safe to re-irradiate the pelvis after definitive prostate brachytherapy?

Eight years after brachytherapy for a low risk prostate cancer, a patient has unresectable high grade squamous cell carcinoma of the bladder. Should I...

1 Answer available