Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan.
Radiat Oncol. 2011 Aug 21;6:98. doi: 10.1186/1748-717X-6-98.
Reirradiation is a feasible option for patients who do not otherwise have treatment options available. Depending on the location and extent of the tumor, reirradiation may be accomplished with external beam radiotherapy, brachytherapy, radiosurgery, or intensity modulated radiation therapy (IMRT). Although there has been limited experience with hypofractionated stereotactic radiotherapy (hSRT), it may have the potential for curative or palliative treatment due to its advanced precision technology, particularly for limited small lesion. On the other hand, severe late adverse reactions are anticipated with reirradiation than with initial radiation therapy. The risk of severe late complications has been reported to be 20- 40% and is related to prior radiotherapy dose, primary site, retreatment radiotherapy dose, treatment volume, and technique. Early researchers have observed lethal bleeding in such patients up to a rate of 14%. Recently, similar rate of 10-15% was observed for fatal bleeding with use of modern hSRT like in case of carotid blowout syndrome. To determine the feasibility and efficacy of reirradiation using modern technology, we reviewed the pertinent literature. The potentially lethal side effects should be kept in mind when reirradiation by hSRT is considered for treatment, and efforts should be made to minimize the risk in any future investigations.
再放疗是那些没有其他治疗选择的患者的可行选择。根据肿瘤的位置和范围，再放疗可以通过外部束放疗、近距离放疗、放射外科或调强放疗（IMRT）来完成。尽管在分次立体定向放疗（hSRT）方面经验有限，但由于其先进的精确技术，它可能具有治愈或姑息治疗的潜力，特别是对于有限的小病变。另一方面，与初始放射治疗相比，再放疗预计会出现更严重的晚期不良反应。据报道，严重晚期并发症的风险为 20-40%，与先前的放射治疗剂量、原发部位、再治疗放射治疗剂量、治疗体积和技术有关。早期研究人员观察到此类患者致命性出血的发生率高达 14%。最近，在使用现代 hSRT 治疗颈动脉破裂综合征等情况下，致命性出血的发生率类似，为 10-15%。为了确定使用现代技术进行再放疗的可行性和疗效，我们回顾了相关文献。在考虑使用 hSRT 进行再放疗时，应注意潜在的致命副作用，并应努力在任何未来的研究中降低风险。
