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

Radiation Oncology

Matthias Guckenberger¹  Michael Flentje¹  Frederick Mantel¹ 

[1] Department of Radiation Oncology, University of Wuerzburg, Wuerzburg, Germany

关键词: Pelvic tumors;    Head and neck cancer;    NSCLC;    Spinal metastases;    Normal tissue tolerance;    Locoregional recurrence;    Re-irradiation;    Radiosurgery;    Stereotactic body radiotherapy;   

Others  :  1154771
DOI  :  10.1186/1748-717X-8-7

 received in 2012-12-21, accepted in 2012-12-27,  发布年份 2013

【 摘 要 】

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.

【 授权许可】

   
2013 Mantel et al.; licensee BioMed Central Ltd.

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