![]() ![]() 5 The number of patients being treated with reirradiation is increasing. 2, 3, 4 We estimate 700 patients with NSCLC annually in the United Kingdom would develop either a new primary or local recurrence (based on UK audit data), for whom reirradiation may be a treatment option. In the setting of non-small cell lung cancer (NSCLC), local relapse occurs in a third of patients 2 years after radical radiation therapy, and the rate of second primary lung cancers at 10 years is 14%. Given this heterogeneity, the reported efficacy of high-dose re-treatment strategies vary widely with a median overall survival (OS) between 11.1 and 24 months. The majority of the studies of thoracic reirradiation are retrospective reports, group different clinical situations together, and lack consistent reirradiation doses or techniques. High-level evidence to guide practice of radical thoracic reirradiation is lacking. Each scenario will have different underpinning tumor biology, outcomes, and toxicities. ![]() Repeat irradiation can be used in several different clinical scenarios: for locally recurrent lung tumors, a metachronous lung tumor distant from a previously irradiated lung tumor, a new lung tumor arising in the previous radiation therapy field of a different histologic tumor, or to metastatic disease overlapping with a previous treatment. Curative-intent thoracic reirradiation is a second or subsequent course of radiation therapy to the chest with the goal of long-term disease control. ![]()
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