Stereotactic body radiation therapy in the re-irradiation situation – a review

Although locoregional relapse is frequent after definitive radiotherapy (RT) or multimodal treatments, re-irradiation is only performed in few patients even in palliative settings like e.g. vertebral metastasis. This is most due to concern about potentially severe complications, especially when larg...

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Main Authors:	Mantel, Frederick, Flentje, Michael, Guckenberger, Matthias
Format:	Online
Language:	English
Published:	BioMed Central 2013
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3552718/

id	pubmed-3552718
recordtype	oai_dc
spelling	pubmed-35527182013-01-28 Stereotactic body radiation therapy in the re-irradiation situation – a review Mantel, Frederick Flentje, Michael Guckenberger, Matthias Review Although locoregional relapse is frequent after definitive radiotherapy (RT) or multimodal treatments, re-irradiation is only performed in few patients even in palliative settings like e.g. vertebral metastasis. This is most due to concern about potentially severe complications, especially when large volumes are exposed to re-irradiation. With technological advancements in treatment planning the interest in re-irradiation as a local treatment approach has been reinforced. Recently, several studies reported re-irradiation for spinal metastases using SBRT with promising local and symptom control rates and simultaneously low rates of toxicity. These early data consistently indicate that SBRT is a safe and effective treatment modality in this clinical situation, where other treatment alternatives are rare. Similarly, good results have been shown for SBRT in the re-irradiation of head and neck tumors. Despite severe late adverse effects were reported in several studies, especially after single fraction doses >10 Gy, they appear less frequently compared to conventional radiotherapy. Few studies with small patient numbers have been published on SBRT re-irradiation for non-small cell lung cancer (NSCLC). Overall survival (OS) is limited by systemic progression and seems to depend particularly on patient selection. SBRT re-irradiation after primary SBRT should not be practiced in centrally located tumors due to high risk of severe toxicity. Only limited data is available for SBRT re-irradiation of pelvic tumors: feasibility and acceptable toxicity has been described, suggesting SBRT as a complementary treatment modality for local symptom control. BioMed Central 2013-01-05 /pmc/articles/PMC3552718/ /pubmed/23289496 http://dx.doi.org/10.1186/1748-717X-8-7 Text en Copyright ©2013 Mantel et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Mantel, Frederick Flentje, Michael Guckenberger, Matthias
spellingShingle	Mantel, Frederick Flentje, Michael Guckenberger, Matthias Stereotactic body radiation therapy in the re-irradiation situation – a review
author_facet	Mantel, Frederick Flentje, Michael Guckenberger, Matthias
author_sort	Mantel, Frederick
title	Stereotactic body radiation therapy in the re-irradiation situation – a review
title_short	Stereotactic body radiation therapy in the re-irradiation situation – a review
title_full	Stereotactic body radiation therapy in the re-irradiation situation – a review
title_fullStr	Stereotactic body radiation therapy in the re-irradiation situation – a review
title_full_unstemmed	Stereotactic body radiation therapy in the re-irradiation situation – a review
title_sort	stereotactic body radiation therapy in the re-irradiation situation – a review
description	Although locoregional relapse is frequent after definitive radiotherapy (RT) or multimodal treatments, re-irradiation is only performed in few patients even in palliative settings like e.g. vertebral metastasis. This is most due to concern about potentially severe complications, especially when large volumes are exposed to re-irradiation. With technological advancements in treatment planning the interest in re-irradiation as a local treatment approach has been reinforced. Recently, several studies reported re-irradiation for spinal metastases using SBRT with promising local and symptom control rates and simultaneously low rates of toxicity. These early data consistently indicate that SBRT is a safe and effective treatment modality in this clinical situation, where other treatment alternatives are rare. Similarly, good results have been shown for SBRT in the re-irradiation of head and neck tumors. Despite severe late adverse effects were reported in several studies, especially after single fraction doses >10 Gy, they appear less frequently compared to conventional radiotherapy. Few studies with small patient numbers have been published on SBRT re-irradiation for non-small cell lung cancer (NSCLC). Overall survival (OS) is limited by systemic progression and seems to depend particularly on patient selection. SBRT re-irradiation after primary SBRT should not be practiced in centrally located tumors due to high risk of severe toxicity. Only limited data is available for SBRT re-irradiation of pelvic tumors: feasibility and acceptable toxicity has been described, suggesting SBRT as a complementary treatment modality for local symptom control.
publisher	BioMed Central
publishDate	2013
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3552718/
_version_	1611948916952006656

Stereotactic body radiation therapy in the re-irradiation situation – a review

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