Review Article

Stereotactic Hypofractionated Irradiation for Metastatic, Inoperable, and Recurrent Malignancies: A Modern Necessity, rather than a Luxury

Table 11

SABR for reirradiation for relapse after previous irradiation.

TrialSiteMethodResult

Ozyigit et al. [95]NasopharynxRetrospectively compared outcomes of SABR versus 3DCRT+/− brachytherapy.Responses were similar in both arms. However, SABR associated with lesser toxicity.

Iwata et al. [96]Sinonasal51 patients of post-RT recurrent sinonasal malignancies reirradiated with SABR (median dose 60 Gy).Feasible for salvage post-RT. Further innovations needed in fractionation and combination chemotherapy.

Jereczek-Fossa et al. [64]Prostate primary or nodalSABR (median dose of 30 Gy in 4-5 Fc) for reirradiation in 34 patients.Feasible approach for isolated recurrent primary/nodal prostate cancer. Low toxicity. In-field progression in <10% cases.

Dewas et al. [97]Uterocervical, bladder16 patients treated with SABR (6 × 6 Fc) for reirradiation of lateral pelvic recurrences.Offers a short and well-tolerated treatment for lateral pelvic recurrences in previously irradiated patients who are otherwise not treatable.

Sahgal et al. [98]Spine37 patients with history of prior conventional RT and 23 patients with no prior history of RT. Reirradiation with SABR (median dose of 24 Gy in 3 Fc). 2-year overall progression free probability was 85%. No significant difference in survival or local control in patients with or without prior radiotherapy.

Choi et al. [99]SpineRetrospective series (). SABR after prior conventional RT.Reirradiation with SABR provided 1-year LC of 73%. Time interval between prior RT and SABR was predictive of response.

Sterzing et al. [100]Spine. SABR after prior RT.2-year LC of 63%. No incidence of severe toxicity.

Poltinnikov et al. [106]Lung17 NSCLC patients all recurred after prior conventional RT of ≥50 Gy.SABR provided median OS of 5.5 months. 11 of 13 patients who were symptomatic with dyspnoea had improved.

Kelly et al. [107]LungRetrospective study (). SABR on relapse after prior thoracic RT.Excellent in-field tumor control of 92% at 2-years. No grade 4-5 toxicities.

Coon et al. [108]LungSABR for recurrent primary lung lesions after prior RT ().1-year LC was 92%, and 1-year OS was 67%.

3DCRT: three-dimensional conformal radiotherapy; Fc: fraction; LC: local control; OS: overall survival.