Figure 1.

Reirradiation practices. A, Contraindications to reirradiation: Contraindications included size of tumor (18%), poor performance status (70%), edema on imaging (8%), and steroid dependency (11%). Other reasons included short interval to progression, evidence of radiation therapy necrosis, sedation requirements in the child, poor/no clinical response to initial radiotherapy, and intratumoral hemorrhage. B, Time from initial radiation to reirradiation: C, Concurrent therapy used with reirradiation: Concurrent use of systemic agents with reirradiation was considered in 46% of respondents, with targeted agents (37%), biologics (34%), immunotherapy (25%), intravenous chemotherapy (19%), and intrathecal chemotherapy (4%). D, Complications with reirradiation: Complications seen with reirradiation included asymptomatic necrosis (43%), symptomatic necrosis (30%), and bleeding (9%). Other reasons included edema and steroid dependency.