摘要
Up to 90% of patients initially treated with curativeintent radiotherapy(RT) will experience locoregional failure. Historically, reirradiation(Re RT) was offered purely with palliative intent, if considered at all, due to concerns surrounding toxicity, tolerance of normal tissues, and choice of appropriate dose schedule. With technological advancements in RT delivery, coupled with longer survival in many malignancies secondary to improvements in systemic therapy, a small subset of patients presenting with localized recurrence is increasingly being offered salvage Re RT. However, this is largely on an ad hoc basis, guided mainly by small retrospective, single-institution reports. The patient population retreated, RT modality, dose received, degree of attrition and follow-up are extremely variable. The opportunity presently exists to apply lessons learned from the harmonization of the research efforts within the bone metastases community to the salvage Re RT situation: the adoption of common endpoints, minimum features to be incorporated into clinical trial design, and methods of data analysis and reporting. The Re RT data available must be harmonized so that valid, clinically applicable conclusions can be drawn. Collaboration in the form of an international registry of prospectively collected outcomes of patients reirradiated for cure for a variety of tumour sites would further support the evolution of Radiation Oncology towards personalized medicine, and away from the current "one-dose-fits-all" approach.
Up to 90% of patients initially treated with curative-intent radiotherapy （RT） will experience locoregional failure. Historically, reirradiation （ReRT） was offered purely with palliative intent, if considered at all, due to concerns surrounding toxicity, tolerance of normal tissues, and choice of appropriate dose schedule. With technological advancements in RT delivery, coupled with longer survival in many malignancies secondary to improvements in systemic therapy, a small subset of patients presenting with localized recurrence is increasingly being offered salvage ReRT. However, this is largely on an ad hoc basis, guided mainly by small retrospective, single-institution reports. The patient population retreated, RT modality, dose received, degree of attrition and follow-up are extremely variable. The opportunity presently exists to apply lessons learned from the harmonization of the research efforts within the bone metastases community to the salvage ReRT situation： the adoption of common endpoints, minimum features to be incorporated into clinical trial design, and methods of data analysis and reporting. The ReRT data available must be harmonized so that valid, clinicallyapplicable conclusions can be drawn. Collaboration in the form of an international registry of prospectively collected outcomes of patients reirradiated for cure for a variety of tumour sites would further support the evolution of Radiation Oncology towards personalized medicine, and away from the current “one-dose-fits-all” approach.
