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Year : 2018  |  Volume : 1  |  Issue : 1  |  Page : 23-28

Recovery and tolerance of the organs at risk during re-irradiation

1 Department of Radiation Oncology, Queen's NRI Cancer Hospital, Visakhapatnam, Andhra Pradesh, India
2 Mahatma Gandhi Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh, India
3 Department of Radiotherapy, Regional Cancer Centre, JIPMER, Puducherry, India

Correspondence Address:
Dr. Ashutosh Mukherji
Department of Radiotherapy, Regional Cancer Centre, JIPMER, Puducherry - 605 006
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jco.jco_2_17

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In the last few decades, there have been major improvements in diagnosis, staging, and management of cancer which has translated into better disease outcomes and longer survival rates and with better quality of life. This improvement in the quality of life is by better normal tissue sparing caused by the increasing use of newer techniques and technologies, especially in surgery and radiotherapy. Along with higher survival, there is now greater acknowledgment of the need to treat local recurrences and hence the increased use of re-irradiation. Better technology such as intensity modulated radiotherapy translates into better sparing of normal tissue, but at the same time, late toxicity is still of concern. Factors such as residual late damage, total dose, fraction size, technique, type of tissue, and time interval to re-irradiation still guide prescription of the re-irradiation dose. Knowledge of long-term recovery of organ at risk is hence of importance in re-irradiation. This review article has emphasized on the recovery and tolerance of organs at risk such as Spinal cord, Brainstem, and Brain. This is important in prescribing doses for the target volume for re-irradiation and in setting constraints for surrounding critical organs during the planning process.

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