BCRB 2018

Should we re-irradiate

100

Single course N = 3635

• Risk of late damage is higher in retreated patients… • But cumulative total dose for 20% complication rate at 5 y is higher than predicted from single course treatment (EQD2 3 = 86 vs 67 Gy) indicating partial recovery!

80

60

40

Reirradiation N = 487

20

Complication free survival (%) 0 2 4 0

6

8

10

Time from (re)irradiation (years)

Lee AWM et al. Int J Radiat Oncol Biol Phys 2000

Duprez et al R&O 2014

Claes Mercke Stockholm 2018