Interdisciplinary Approach Toward Reirradiation of Cancer Patients

TL;DR

This paper reviews how cancer patients are re-treated with radiation after recurrence, focusing on factors and interdisciplinary approaches involved in decision-making.

Contribution

The paper provides insights into the decision-making process and interdisciplinary care for reirradiation of cancer patients.

Findings

Factors like previous RT site and dose influence re-RT decisions.

There is global variation in re-RT workflow and decision-making practices.

Understanding radiobiology helps determine safe doses for re-RT.

Abstract

As systemic therapies, alongside radiation, for cancer treatment continue to evolve, the radiation oncology community is facing an increasing number of reirradiation (re-RT) of tumor sites subject to recurrences. There are multiple factors associated with choosing re-RT as a treatment option for a previously irradiated site. The factors include the site of previous radiotherapy (RT), the current extent of the disease, the nature of recurrence, the technique used for previous irradiation, and the previous RT details including dose and dose fractionation. There is a persistent heterogeneity in the workflow and decision-making in cancer care centers worldwide. The current review is an attempt to dive into the practices of decision-making for re-RT, interdisciplinary attention given to the re-RT patients, and acceptable doses to the organ at risk (OAR) deduced from the understanding of previous RT and radiobiology of the tumor and sites evidence of better techniques for effective execution.

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