Clinical workflow for reirradiation: national consensus recommendations on imaging, treatment planning, dose accumulation, and treatment delivery
DOI:
https://doi.org/10.2340/1651-226X.2025.43567Keywords:
Reirradiation, Workflow, Radiotherapy, National GuidelinesAbstract
Background and purpose: Reirradiation is becoming more frequent in clinical practice. However, workflows and practices vary widely between clinics, as general guidelines are scarce or lacking in practical detail. This paper presents comprehensive national Danish consensus recommendations covering all steps of the reirradiation workflow. The aim is to standardise and improve reirradiation treatment quality and provide guidance for much-needed large-scale clinical trials.
Methods: An expert panel was formed comprising physicians, clinical physicists, and clinical researchers from all Danish radiotherapy centres. An in-person 2-day workshop was followed by multiple online meetings. Recommendations were based on expert consensus, supported by review of existing literature, and were reviewed by all Danish Multidisciplinary Cancer Groups before publication.
Results: Reirradiation cases should be designated clearly as such at each workflow step. Review of patient cases at multidisciplinary reirradiation conferences is encouraged. Immobilisation, positioning, and motion management should resemble that of previous treatment(s) as closely as possible. Information on previous dose should be used in planning and evaluation. The degree of complexity (e.g. summation of dose maxima, rigid/deformable image registration, 3D dose accumulation) should reflect the clinical situation as well as the extent/quality of available information. Dose should always be converted to an equieffective dose before summation. Daily image-guidance and regular evaluation of delivered dose are recommended. We provide guidance on quality assurance of dose mapping and guidelines for clinical reirradiation trials.
Interpretation: We present national consensus guidelines for site-independent reirradiation treatment workflows. The guidelines have been approved by the site-specific Danish Multidisciplinary Cancer Groups.
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References
Bryant AK, Banegas MP, Martinez ME, Mell LK, Murphy JD. Trends in radiation therapy among cancer survivors in the United States, 2000–2030. Cancer Epidemiol Biomark Prev. 2017;26:963–70.
https://doi.org/10.1158/1055-9965.EPI-16-1023 DOI: https://doi.org/10.1158/1055-9965.EPI-16-1023
Paradis KC, Mayo C, Owen D, Spratt DE, Hearn J, Rosen B, et al. The special medical physics consult process for reirradiation patients. Adv Radiat Oncol. 2019;4:559–65.
https://doi.org/10.1016/j.adro.2019.05.007 DOI: https://doi.org/10.1016/j.adro.2019.05.007
Christ SM, Ahmadsei M, Wilke L, Kühnis A, Pavic M, Tanadini-Lang S, et al. Long-term cancer survivors treated with multiple courses of repeat radiation therapy. Radiat Oncol. 2021;16:208.
https://doi.org/10.1186/s13014-021-01934-y DOI: https://doi.org/10.1186/s13014-021-01934-y
Nieder C, Langendijk JA, Guckenberger M, Grosu AL. Prospective randomized clinical studies involving reirradiation: lessons learned. Strahlenther Onkol. 2016;192:679–86.
https://doi.org/10.1007/s00066-016-1024-6 DOI: https://doi.org/10.1007/s00066-016-1024-6
Nieder C, Willmann J, Andratschke NH. Prospective randomized clinical studies involving reirradiation: update of a systematic review. Strahlenther Onkol. 2023;199:787–97.
https://doi.org/10.1007/s00066-023-02118-1 DOI: https://doi.org/10.1007/s00066-023-02118-1
Andratschke N, Willmann J, Appelt AL, Alyamani N, Balermpas P, Baumert BG, et al. European Society for Radiotherapy and Oncology and European Organisation for Research and Treatment of Cancer consensus on re-irradiation: definition, reporting, and clinical decision making. Lancet Oncol. 2022;23:e469–78.
https://doi.org/10.1016/S1470-2045(22)00447-8 DOI: https://doi.org/10.1016/S1470-2045(22)00447-8
Armstrong S, Hoskin P. Complex clinical decision-making process of re-irradiation. Clin Oncol. 2020;32:688–703.
https://doi.org/10.1016/j.clon.2020.07.023 DOI: https://doi.org/10.1016/j.clon.2020.07.023
Beddok A, Willmann J, Embring A, Appelt AL, Balermpas P, Chua K, et al. Reirradiation: standards, challenges, and patient‐focused strategies across tumor types. CA A Cancer J Clin. 2025;caac.70016.
https://doi.org/10.3322/caac.70016 DOI: https://doi.org/10.3322/caac.70016
Nieder C, Langendijk JA, Guckenberger M, Grosu AL. Second re-irradiation: a narrative review of the available clinical data. Acta Oncol. 2018;57:305–10.
https://doi.org/10.1080/0284186X.2017.1409433 DOI: https://doi.org/10.1080/0284186X.2017.1409433
Gabrys D, Kulik R, Namysł-Kaletka A. Re-irradiation for intra-thoracic tumours and extra-thoracic breast cancer: dose accumulation, evaluation of efficacy and toxicity based on a literature review. Br J Radiol. 2022;95:20201292.
https://doi.org/10.1259/bjr.20201292 DOI: https://doi.org/10.1259/bjr.20201292
Dörr W, Gabryś D. The principles and practice of re-irradiation in clinical oncology: an overview. Clin Oncol. 2018;30:67–72.
https://doi.org/10.1016/j.clon.2017.11.014 DOI: https://doi.org/10.1016/j.clon.2017.11.014
Rulach R, Hanna GG, Franks K, McAleese J, Harrow S. Re-irradiation for locally recurrent lung cancer: Evidence, risks and benefits. Clin Oncol. 2018;30:101–9.
https://doi.org/10.1016/j.clon.2017.11.003 DOI: https://doi.org/10.1016/j.clon.2017.11.003
Rulach R, Ball D, Chua KLM, Dahele M, De Ruysscher D, Franks K, et al. An international expert survey on the indications and practice of radical thoracic reirradiation for non-small cell lung cancer. Adv Radiat Oncol. 2021;6:100653.
https://doi.org/10.1016/j.adro.2021.100653 DOI: https://doi.org/10.1016/j.adro.2021.100653
Ng WT, Soong YL, Ahn YC, AlHussain H, Choi HCW, Corry J, et al. International recommendations on reirradiation by intensity modulated radiation therapy for locally recurrent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2021;110:682–95.
https://doi.org/10.1016/j.ijrobp.2021.01.041 DOI: https://doi.org/10.1016/j.ijrobp.2021.01.041
Andratschke N, Heusel A, Albert NL, Alongi F, Baumert BG, Belka C, et al. ESTRO/EANO recommendation on reirradiation of glioblastoma. Radiother Oncol. 2025;204:110696.
https://doi.org/10.1016/j.radonc.2024.110696 DOI: https://doi.org/10.1016/j.radonc.2024.110696
Hannoun-Levi J-M, Gal J, Polgar C, Strnad V, Loessl K, Polat B, et al. Second conservative treatment for local recurrence breast cancer: a GEC-ESTRO oncological outcome and prognostic factor analysis. Int J Radiat Oncol Biol Phys. 2023;117:1200–10.
https://doi.org/10.1016/j.ijrobp.2023.06.075 DOI: https://doi.org/10.1016/j.ijrobp.2023.06.075
Slevin F, Aitken K, Alongi F, Arcangeli S, Chadwick E, Chang AR, et al. An international Delphi consensus for pelvic stereotactic ablative radiotherapy re-irradiation. Radiother Oncol. 2021;164:104–14.
https://doi.org/10.1016/j.radonc.2021.09.010 DOI: https://doi.org/10.1016/j.radonc.2021.09.010
Ward MC, Lee NY, Caudell JJ, Zajichek A, Awan MJ, Koyfman SA, et al. A competing risk nomogram to predict severe late toxicity after modern re-irradiation for squamous carcinoma of the head and neck. Oral Oncol. 2019;90:80–6.
https://doi.org/10.1016/j.oraloncology.2019.01.022 DOI: https://doi.org/10.1016/j.oraloncology.2019.01.022
Embring A, Onjukka E, Mercke C, Lax I, Berglund A, Bornedal S, et al. Overlapping volumes in re-irradiation for head and neck cancer – an important factor for patient selection. Radiat Oncol. 2020;15:147.
https://doi.org/10.1186/s13014-020-01587-3 DOI: https://doi.org/10.1186/s13014-020-01587-3
Takiar V, Garden AS, Ma D, Morrison WH, Edson M, Zafereo ME, et al. Reirradiation of head and neck cancers with intensity modulated radiation therapy: outcomes and analyses. Int J Radiat Oncol Biol Phys. 2016;95:1117–31.
https://doi.org/10.1016/j.ijrobp.2016.03.015 DOI: https://doi.org/10.1016/j.ijrobp.2016.03.015
Stiefel I, Schröder C, Tanadini-Lang S, Pytko I, Vu E, Klement RJ, et al. High-dose re-irradiation of intracranial lesions – efficacy and safety including dosimetric analysis based on accumulated EQD2Gy dose calculation. Clin Transl Radiat Oncol. 2021;27:132–8.
https://doi.org/10.1016/j.ctro.2021.01.011 DOI: https://doi.org/10.1016/j.ctro.2021.01.011
Schröder C, Stiefel I, Tanadini-Lang S, Pytko I, Vu E, Guckenberger M, et al. Re-irradiation in the thorax – an analysis of efficacy and safety based on accumulated EQD2 doses. Radiother Oncol. 2020;152:56–62.
https://doi.org/10.1016/j.radonc.2020.07.033 DOI: https://doi.org/10.1016/j.radonc.2020.07.033
Yamazaki H, Suzuki G, Aibe N, Nakamura S, Yoshida K, Oh R, et al. A surveillance study of patterns of reirradiation practice using external beam radiotherapy in Japan. J Radiat Res. 2021;62:285–93.
https://doi.org/10.1093/jrr/rraa112 DOI: https://doi.org/10.1093/jrr/rraa112
Ayadi M, Dupuis P, Baudier T, Padovani L, Sarrut D, Sunyach M-P. Management of reirradiations: a clinical and technical overview based on a French survey. Phys Med. 2023;109:102582.
https://doi.org/10.1016/j.ejmp.2023.102582 DOI: https://doi.org/10.1016/j.ejmp.2023.102582
Price RA, Jin L, Meyer J, Chen L, Lin T, Eldib A, et al. Practical clinical implementation of the special physics consultation process in the re-irradiation environment. Adv Radiat Oncol. 2021;6:100594.
https://doi.org/10.1016/j.adro.2020.09.027 DOI: https://doi.org/10.1016/j.adro.2020.09.027
Di Franco R, Pezzulla D, Arcidiacono F, Pontoriero A, Cellini F, Belgioia L, et al. Reirradiation on spine metastases: an Italian survey on behalf of palliative care and reirradiation study groups of Italian association of radiotherapy and clinical oncology (AIRO). Clin Transl Oncol. 2022;25:408–16.
https://doi.org/10.1007/s12094-022-02951-3 DOI: https://doi.org/10.1007/s12094-022-02951-3
Harrow S, Sadozye A, King AP, Hudson E, Boyce H, Fenwick J, et al. Principles of reirradiation. The Royal College of Radiologists. 63 Lincoln’s Inn Fields, London, 2024, p. 1–11.
Paradis KC, Matuszak MM. The medical physics management of reirradiation patients. Semin Radiat Oncol. 2020;30:204–11.
https://doi.org/10.1016/j.semradonc.2020.02.008 DOI: https://doi.org/10.1016/j.semradonc.2020.02.008
Krauze AV, Attia A, Braunstein S, Chan M, Combs SE, Fietkau R, et al. Expert consensus on re-irradiation for recurrent glioma. Radiat Oncol. 2017;12:194.
https://doi.org/10.1186/s13014-017-0928-3 DOI: https://doi.org/10.1186/s13014-017-0928-3
West N, Covington E, Vasquez Osorio E, Stroom J, Duchateau M, Day M, et al. Consistency in reirradiation scenarios: terminology, tissue recovery in calculations, units and reporting. Radiother Oncol. 2025;202:110587.
https://doi.org/10.1016/j.radonc.2024.110587 DOI: https://doi.org/10.1016/j.radonc.2024.110587
Krogh SL, Brink C, Lorenzen EL, Samsøe E, Vogelius IR, Zukauskaite R, et al. A national repository of complete radiotherapy plans: design, Results, and experiences. Acta Oncol. 2023;62:1161–68.
https://doi.org/10.1080/0284186X.2023.2270143 DOI: https://doi.org/10.1080/0284186X.2023.2270143
Brock KK, Mutic S, McNutt TR, Li H, Kessler ML. Use of image registration and fusion algorithms and techniques in radiotherapy: report of the AAPM Radiation Therapy Committee Task Group No. 132. Med Phys. 2017;44:e43–76.
https://doi.org/10.1002/mp.12256 DOI: https://doi.org/10.1002/mp.12256
Chetty IJ, Rosu-Bubulac M. Deformable registration for dose accumulation. Semin Radiat Oncol. 2019;29:198–208.
https://doi.org/10.1016/j.semradonc.2019.02.002 DOI: https://doi.org/10.1016/j.semradonc.2019.02.002
Hussein M, Akintonde A, McClelland J, Speight R, Clark CH. Clinical use, challenges, and barriers to implementation of deformable image registration in radiotherapy – the need for guidance and QA tools. Br J Radiol. 2021;94:20210001.
https://doi.org/10.1259/bjr.20210001 DOI: https://doi.org/10.1259/bjr.20210001
Murr M, Brock KK, Fusella M, Hardcastle N, Hussein M, Jameson MG, et al. Applicability and usage of dose mapping/accumulation in radiotherapy. Radiother Oncol. 2023;182:109527.
https://doi.org/10.1016/j.radonc.2023.109527 DOI: https://doi.org/10.1016/j.radonc.2023.109527
Nenoff L, Amstutz F, Murr M, Archibald-Heeren B, Fusella M, Hussein M, et al. Review and recommendations on deformable image registration uncertainties for radiotherapy applications. Phys Med Biol. 2023;68:24TR01.
https://doi.org/10.1088/1361-6560/ad0d8a DOI: https://doi.org/10.1088/1361-6560/ad0d8a
Paganelli C, Meschini G, Molinelli S, Riboldi M, Baroni G. Patientspecific validation of deformable image registration in radiation therapy: Overview and caveats. Med Phys 2018;45:e908–e922. DOI: https://doi.org/10.1002/mp.13162
Korevaar EW, Habraken SJM, Scandurra D, Kierkels RGJ, Unipan M, Eenink MGC, et al. Practical robustness evaluation in radiotherapy – A photon and proton-proof alternative to PTV-based plan evaluation. Radiother Oncol 2019;141:267–74 DOI: https://doi.org/10.1016/j.radonc.2019.08.005
Saleh-Sayah NK, Weiss E, Salguero FJ, Siebers JV. A distance to dose difference tool for estimating the required spatial accuracy of a displacement vector field: distance to dose difference analysis. Med Phys. 2011;38:2318–23.
https://doi.org/10.1118/1.3572228 DOI: https://doi.org/10.1118/1.3572228
Grégoire V, Evans M, Le Q-T, Bourhis J, Budach V, Chen A, et al. Delineation of the primary tumour Clinical Target Volumes (CTV-P) in laryngeal, hypopharyngeal, oropharyngeal and oral cavity squamous cell carcinoma: AIRO, CACA, DAHANCA, EORTC, GEORCC, GORTEC, HKNPCSG, HNCIG, IAG-KHT, LPRHHT, NCIC CTG, NCRI, NRG Oncology, PHNS, SBRT, SOMERA, SRO, SSHNO, TROG consensus guidelines. Radiother Oncol. 2018;126:3–24.
https://doi.org/10.1016/j.radonc.2017.10.016 DOI: https://doi.org/10.1016/j.radonc.2017.10.016
Brouwer CL, Steenbakkers RJHM, Bourhis J, Budach W, Grau C, Grégoire V, et al. CT-based delineation of organs at risk in the head and neck region: DAHANCA, EORTC, GORTEC, HKNPCSG, NCIC CTG, NCRI, NRG Oncology and TROG consensus guidelines. Radiother Oncol. 2015;117:83–90.
https://doi.org/10.1016/j.radonc.2015.07.041 DOI: https://doi.org/10.1016/j.radonc.2015.07.041
Offersen BV, Boersma LJ, Kirkove C, Hol S, Aznar MC, Biete Sola A, et al. ESTRO consensus guideline on target volume delineation for elective radiation therapy of early stage breast cancer. Radiother Oncol. 2015;114:3–10.
https://doi.org/10.1016/j.radonc.2014.11.030 DOI: https://doi.org/10.1016/j.radonc.2014.11.030
Salembier C, Villeirs G, De Bari B, Hoskin P, Pieters BR, Van Vulpen M, et al. ESTRO ACROP consensus guideline on CT- and MRI-based target volume delineation for primary radiation therapy of localized prostate cancer. Radiother Oncol. 2018;127:49–61.
https://doi.org/10.1016/j.radonc.2018.01.014 DOI: https://doi.org/10.1016/j.radonc.2018.01.014
Matrosic CK, Andrzejewski P, Bergman A, Chng N, Naqa IE, Freislederer P, et al. Software support tools for reirradiation: a report from Reirradiation Collaborative Group (ReCOG) 2024. Int J Radiat Oncol Biol Phys. 2025;122:181–5.
https://doi.org/10.1016/j.ijrobp.2024.12.023 DOI: https://doi.org/10.1016/j.ijrobp.2024.12.023
Nix M, Gregory S, Aldred M, Aspin L, Lilley J, Al-Qaisieh B, et al. Dose summation and image registration strategies for radiobiologically and anatomically corrected dose accumulation in pelvic re-irradiation. Acta Oncol. 2022;61:64–72.
https://doi.org/10.1080/0284186X.2021.1982145 DOI: https://doi.org/10.1080/0284186X.2021.1982145
Meyer S, Zhang L, Liu Y, Kuo LC, Hu Y-C, Yamada Y, et al. Automated planning of stereotactic spine re-irradiation using cumulative dose limits. Phys Imaging Radiat Oncol. 2024;29:100547.
https://doi.org/10.1016/j.phro.2024.100547 DOI: https://doi.org/10.1016/j.phro.2024.100547
Bentzen SM, Dörr W, Gahbauer R, Howell RW, Joiner MC, Jones B, et al. Bioeffect modeling and equieffective dose concepts in radiation oncology – terminology, quantities and units. Radiother Oncol. 2012;105:266–8.
https://doi.org/10.1016/j.radonc.2012.10.006 DOI: https://doi.org/10.1016/j.radonc.2012.10.006
Joiner MC, Van Der Kogel AJ, editors. Basic clinical radiobiology. Boca Raton, Florida, USA 5th ed. CRC Press.
Nieder C, Grosu AL, Andratschke NH, Molls M. Update of human spinal cord reirradiation tolerance based on additional data from 38 patients. Int J Radiat Oncol Biol Phys. 2006;66:1446–9.
https://doi.org/10.1016/j.ijrobp.2006.07.1383 DOI: https://doi.org/10.1016/j.ijrobp.2006.07.1383
Kirkpatrick JP, Van der Kogel AJ, Schultheiss TE. Radiation dose–volume effects in the spinal cord. Int J Radiat Oncol Biol Phys. 2010;76:S42–9.
https://doi.org/10.1016/j.ijrobp.2009.04.095 DOI: https://doi.org/10.1016/j.ijrobp.2009.04.095
Nieder C, Gaspar LE, Ruysscher DD, Guckenberger M, Mehta MP, Rusthoven CG, et al. Repeat reirradiation of the spinal cord: multi-national expert treatment recommendations. Strahlenther Onkol. 2018;194:365–74.
https://doi.org/10.1007/s00066-018-1266-6 DOI: https://doi.org/10.1007/s00066-018-1266-6
Stewart FA, Van der Kogel AJ. Retreatment tolerance of normal tissues. Semin Radiat Oncol. 1994;4:103–11.
https://doi.org/10.1016/S1053-4296(05)80037-2 DOI: https://doi.org/10.1016/S1053-4296(05)80037-2
Nieder C, Milas L, Ang KK. Tissue tolerance to reirradiation. Semin Radiat Oncol. 2000;10:200–9.
https://doi.org/10.1053/srao.2000.6593 DOI: https://doi.org/10.1053/srao.2000.6593
Yan D, Vicini F, Wong J, Martinez A. Adaptive radiation therapy. Phys Med Biol. 1997;42:123–32.
https://doi.org/10.1088/0031-9155/42/1/008 DOI: https://doi.org/10.1088/0031-9155/42/1/008
Sonke J-J, Aznar M, Rasch C. Adaptive radiotherapy for anatomical changes. Semin Radiat Oncol. 2019;29:245–57.
https://doi.org/10.1016/j.semradonc.2019.02.007 DOI: https://doi.org/10.1016/j.semradonc.2019.02.007
Lim-Reinders S, Keller BM, Al-Ward S, Sahgal A, Kim A. Online adaptive radiation therapy. Int J Radiat Oncol Biol Phys. 2017;99:994–1003.
https://doi.org/10.1016/j.ijrobp.2017.04.023 DOI: https://doi.org/10.1016/j.ijrobp.2017.04.023
Møller DS, Lutz CM, Khalil AA, Alber M, Holt MI, Kandi M, et al. Survival benefits for non-small cell lung cancer patients treated with adaptive radiotherapy. Radiother Oncol. 2022;168:234–40.
https://doi.org/10.1016/j.radonc.2022.01.039 DOI: https://doi.org/10.1016/j.radonc.2022.01.039
Giacometti V, King RB, Agnew CE, Irvine DM, Jain S, Hounsell AR, et al. An evaluation of techniques for dose calculation on cone beam computed tomography. Br J Radiol. 2019;92:20180383.
https://doi.org/10.1259/bjr.20180383 DOI: https://doi.org/10.1259/bjr.20180383
Elstrøm UV, Wysocka BA, Muren LP, Petersen JBB, Grau C. Daily kV cone-beam CT and deformable image registration as a method for studying dosimetric consequences of anatomic changes in adaptive IMRT of head and neck cancer. Acta Oncol. 2010;49:1101–8.
https://doi.org/10.3109/0284186X.2010.500304 DOI: https://doi.org/10.3109/0284186X.2010.500304
Posiewnik M, Piotrowski T. A review of cone-beam CT applications for adaptive radiotherapy of prostate cancer. Phys Med. 2019;59:13–21.
https://doi.org/10.1016/j.ejmp.2019.02.014 DOI: https://doi.org/10.1016/j.ejmp.2019.02.014
Thing RS, Nilsson R, Andersson S, Berg M, Lund MD. Evaluation of CBCT based dose calculation in the thorax and pelvis using two generic algorithms. Phys Med. 2022;103:157–65.
https://doi.org/10.1016/j.ejmp.2022.10.012 DOI: https://doi.org/10.1016/j.ejmp.2022.10.012
Chan A-W, Tetzlaff JM, Altman DG, Laupacis A, Gøtzsche PC, Krleža-Jerić K, et al. SPIRIT 2013 statement: defining standard protocol items for clinical trials. Ann Intern Med. 2013;158:200.
https://doi.org/10.7326/0003-4819-158-3-201302050-00583 DOI: https://doi.org/10.7326/0003-4819-158-3-201302050-00583
Butcher NJ, Monsour A, Mew EJ, Chan A-W, Moher D, Mayo-Wilson E, et al. Guidelines for reporting outcomes in trial reports: the CONSORT-outcomes 2022 extension. JAMA. 2022;328:2252.
https://doi.org/10.1001/jama.2022.21022 DOI: https://doi.org/10.1001/jama.2022.21022
Calvert M, Kyte D, Mercieca-Bebber R, Slade A, Chan A-W, King MT, et al. Guidelines for inclusion of patient-reported outcomes in clinical trial protocols: the SPIRIT-PRO extension. JAMA. 2018;319:483.
https://doi.org/10.1001/jama.2017.21903 DOI: https://doi.org/10.1001/jama.2017.21903
Lievens Y, Borras JM, Grau C. Provision and use of radiotherapy in Europe. Mol Oncol. 2020;14:1461–9.
https://doi.org/10.1002/1878-0261.12690 DOI: https://doi.org/10.1002/1878-0261.12690
Dunscombe P, Grau C, Defourny N, Malicki J, Borras JM, Coffey M, et al. Guidelines for equipment and staffing of radiotherapy facilities in the European countries: final results of the ESTRO-HERO survey. Radiother Oncol. 2014;112:165–77.
https://doi.org/10.1016/j.radonc.2014.08.032 DOI: https://doi.org/10.1016/j.radonc.2014.08.032
Hardcastle N, Vasquez Osorio E, Jackson A, Mayo C, Aarberg AE, Ayadi M, et al. Multi-centre evaluation of variation in cumulative dose assessment in reirradiation scenarios. Radiother Oncol. 2024;194:110184.
https://doi.org/10.1016/j.radonc.2024.110184 DOI: https://doi.org/10.1016/j.radonc.2024.110184
Vasquez Osorio E, Mayo C, Jackson A, Appelt A. Challenges of re-irradiation: a call to arms for physicists – and radiotherapy vendors. Radiother Oncol. 2023;182:109585.
https://doi.org/10.1016/j.radonc.2023.109585 DOI: https://doi.org/10.1016/j.radonc.2023.109585
Murray L, Thompson C, Pagett C, Lilley J, Al-Qaisieh B, Svensson S, et al. Treatment plan optimisation for reirradiation. Radiother Oncol. 2023;182:109545.
https://doi.org/10.1016/j.radonc.2023.109545 DOI: https://doi.org/10.1016/j.radonc.2023.109545
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Copyright (c) 2025 Laura P. Kaplan, Rebecca J. Tobin, Ane Appelt, Eliana Vasquez Osorio, Isak Wahlstedt, Rasmus L. Christiansen, Martin S. Nielsen, Laura A. Rechner, Simon N. Thomsen, Mikkel D. Lund, Kenneth Jensen, Camilla Kronborg, Lone Hoffmann
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