Table 4.
Publications evaluating the role of re-irradiation
| Study | No. of patients | reRT | Median OS after progression (months) | Toxicity | Symptomatic relief with reRT | Notes |
|---|---|---|---|---|---|---|
| Elhemaly et al., retrospective (2022) | 56 (re-irradiated) | 2 Gy/20–26 Gy | N/A | N/A | 50% (28/56) | – |
| 24 (no re-irradiated) | ||||||
| Janssens et al., retrospective (2017) | 31 (re-irradiated) | 1.8–3 Gy/18–30 Gy | 4 (progression <6 months) | No ≥ grade 3 toxicity | 77% (24/31) | Improved OS with reRT |
| 39 (no re-irradiated) | 6.4 (progression >6 months) | |||||
| Krishnatry et al., retrospective (2021) | 20 (all re-irradiated) | 1.8 Gy/21.6–45 Gy | 5.5 | 2 (10%) grade 5 toxicity = ITH | 65% (13/20) | ITHs were observed with reRT 43.2 and 45 Gy |
| Mankuzhy et al., retrospective (2024) | 20 (all re-irradiated) | 2–3 Gy/20–36 Gy | 8.2 (2 Gy/fraction) | None | 85% (17/20) | – |
| 7.5 (3 Gy/fraction) | ||||||
| Wawrzuta et al., retrospective (2024) | 18 (re-irradiated) | 2 Gy/20–24 Gy | 7.3 | 4 (22%) increased intracranial pressure, all grade ≤ 2 | 78% (14/18) | Improved OS with reRT |
| 25 (no re-irradiated) | ||||||
| Lassaletta et al., retrospective (2018) | 16 (all re-irradiated) | 1.8–3 Gy/21.6–36 Gy | 6.5 | 1 (6%) pontine necrosis, unknown grade | 81.3% (13/16) | Pontine necrosis with 3 Gy/30 Gy reRT |
| Our study, retrospective (2025) | 15 (re-irradiated) | 1.8–2.5 Gy/19.8–36 Gy | 6 | None | 75% (9/12) | Improved OS with reRT |
| 18 (no re-irradiated) | ||||||
| Kline et al., retrospective (2018) | 12 (re-irradiated) | 2–3 Gy/24–36 Gy | 6 (without nivolumab) | 1 (8%) grade 4 hyponatremia related to maintenance nivolumab | 100% (12/12) | Improved OS with reRT |
| 19 (no re-irradiated) | 6.8 (with nivolumab) | |||||
| Amsbaugh et al., prospective phase I/II (2019) | 12 (all re-irradiated) | 2–2.2 Gy/24–30.8 Gy | 5.8 | 1 (8%) grade 3 hypoxia and dysphagia | 83% (10/12) | 24 Gy arm had highest utility |
| Massimino et al., prospective (2014) | 11 (re-irradiated) | 1.8/19.8 Gy | 6 | 2 (18%) acute respiratory infection, unknown grade | 91% (10/11) | – |
| 5 (no re-irradiated) | ||||||
| 9 (no relapsed) | ||||||
| Vanan et al., retrospective (2015) | 10 (re-irradiated) | 1.8 Gy/21.6–36 Gy | 9 | 4 (40%) fatigue, 1 (10%) vomiting, 1 (10%) insomnia, 1 (10%) weakness, 1 (10%) decreased energy, 1 (10%) decreased appetite, unknown grade | 80% (8/10) | Improved OS with reRT |
| 46 (no re-irradiated) | ||||||
| Khatua et al., retrospective (2014) | 6 (all re-irradiated) | 2 Gy/20 Gy | 7 | None | 100% (6/6) | – |
| Fontanilla et al., retrospective (2012) | 5 (all re-irradiated) | 2 Gy/18–20 Gy | 6 | 2 (40%) fatigue, 2 (40%) alopecia, 1 (20%) decreased appetite, all ≤ grade 2 | 80% (4/5) | – |
| Zamora et al., retrospective (2021) | 5 (all re-irradiated) | 2 Gy/20–24 Gy | 3.8 | No ≥ grade 3 toxicity | 80% (4/5) | – |
| Freese et al., retrospective (2017) | 3 (re-irradiated) | 2 Gy/20 Gy | 2 | None | 67% (2/3) | – |
| 23 (no re-irradiated) | ||||||
| Wang et al., retrospective (2019) | 2 (all re-irradiated) | 2 Gy/24 Gy | N/A | 1 (50%) asymptomatic thrombocytopenia | 100% (2/2) | reRT with concurrent panobinostat |
| Andres et al., retrospective (2017) | 2 (all re-irradiated) | 1.8–2 Gy/20–30.6 Gy | 12.5 | None | 100% (2/2) | Both received a second course of reRT |
ITH intratumoral hemorrhage, N/A not available, OS overall survival, reRT reirradiation