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Year : 2018  |  Volume : 1  |  Issue : 1  |  Page : 40-42

Re-irradiation in central nervous system tumors

1 Department of Radiation Oncology, Apollo Cancer Institute, Hyderabad, Telangana, India
2 Department of Radiation Oncology, Mahatma Gandhi Cancer Hospital, Vishakhapatnam, Andhra Pradesh, India

Correspondence Address:
Dr. Sayan Paul
Apollo Health City Hospital, Jubilee Hills, Hyderabad
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jco.jco_11_17

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Radiotherapy (RT) in relapsed brain tumors has been used sparingly because of the risk of toxicity, particularly white matter necrosis. However, evidence from preclinical animal models and increasing data from clinical series show that brain and spinal cord have marked repair potential, and re irradiation should be considered a valid option in selected patients. The choice of technique and dose fractionation for re irradiation depends on tumor characteristics (volume and location), previous RT dose and volume, and patient characteristics (age and performance status). For small volume tumors in noneloquent areas, single fraction SRS and brachytherapy may be good options. For small and intermediate volume tumors in eloquent areas, FSRT or hypofractionated RT may be used. For large volume recurrences, requiring partial brain irradiation, conventional fractionation is safer and offers palliation with minimal risk of radiation induced toxicitie.

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