Normal Tissue Tolerance to Reirradiation
As a result of longer survival times, even among patients with incurable malignancies, the probability of developing second primary tumours and/or locoregional recurrences in previously irradiated areas might increase. Consequently, the need for additional therapeutic measures providing local control and/or symptom palliation along different lines of treatment has emerged. This has resulted in increasing requests for delivering a second course of radiation to target volumes within or close to previously irradiated anatomical areas. On the one hand, improved imaging and delivery techniques including image-guided and intensity-modulated radiotherapy might facilitate reirradiation of previously exposed regions of the body. On the other hand, late toxicity in several recently reported studies is considerable and may have a devastating impact on health-related quality of life. Therefore, knowledge about long-term recovery of occult radiation injury is of utmost importance. This chapter summarizes available experimental and clinical data on the effects of reirradiation to various organs.
KeywordsLate Toxicity Radiation Therapy Oncology Group Radiation Pneumonitis Biologically Effective Dose Priming Dose
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