Salvage brachytherapy for local recurrence of cancer after definitive irradiation: a GEC-ESTRO narrative review
Hannoun-Levi JM, Strnad V, Eminowicz G, de Iturriaga AG, Smanykó V, Tagliaferri L, Stewart A, Siebert FA (2025)
Publication Type: Journal article, Review article
Publication year: 2025
Journal
Book Volume: 209
Article Number: 110979
DOI: 10.1016/j.radonc.2025.110979
Abstract
The number of irradiated cancer survivors is increasing; mainly for breast, prostate, head-and-neck, uterine and rectal cancers. Due to multiple factors including life expectancy, increasing cancer incidence and intensive cancer treatment improvements, cancer re-irradiation is an increasing phenomenon. Local recurrence of cancer after after definitive irradiation represents one of the most challenging therapeutic scenarios. The goal is to deliver to a pre-irradiated volume, a high dose (achieving secondary local control) while sparing organs at risk from deleterious over-dose (side effects). Among the different re-irradiation techniques, salvage brachytherapy (BT), due to its “Trojan horse” concept, delivers the dose directly inside the target volume with a sharp dose fall-off and low integral dose compared to external beam radiotherapy techniques. GEC-ESTRO aims to report a narrative review of the literature for salvage BT-based cancer re-irradiation for the most frequent cancers (PubMed search key words: local recurrence treatment, re-irradiation, brachytherapy, breast, prostate, head and neck, uterine and rectal cancers). GEC-ESTRO working group representatives reported for each anatomical site; recommendations for patient selection, oncological outcomes and toxicity for salvage BT. Due to its unique physical properties in terms of dose distributions, BT represents a valuable treatment option for cancer local recurrence. For all indications of salvage BT, patient selection is crucial. Shared decision making with the patient about efficacy / benefit and all potential risks represents a key point of the therapeutic decision-making process.
Authors with CRIS profile
Involved external institutions
Centre Antoine Lacassagne (UNICANCER)
France (FR)
University College London Hospitals (UCLH)
United Kingdom (GB)
Biocruces Health Research Institute
Spain (ES)
Semmelweis University / Semmelweis Egyetem
Hungary (HU)
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
Italy (IT)
University of Surrey
United Kingdom (GB)
Universitätsklinikum Schleswig-Holstein (UKSH)
Germany (DE)
France (FR)
University College London Hospitals (UCLH)
United Kingdom (GB)
Biocruces Health Research Institute
Spain (ES)
Semmelweis University / Semmelweis Egyetem
Hungary (HU)
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
Italy (IT)
University of Surrey
United Kingdom (GB)
Universitätsklinikum Schleswig-Holstein (UKSH)
Germany (DE)
How to cite
APA:
Hannoun-Levi, J.M., Strnad, V., Eminowicz, G., de Iturriaga, A.G., Smanykó, V., Tagliaferri, L.,... Siebert, F.A. (2025). Salvage brachytherapy for local recurrence of cancer after definitive irradiation: a GEC-ESTRO narrative review. Radiotherapy and Oncology, 209. https://doi.org/10.1016/j.radonc.2025.110979
MLA:
Hannoun-Levi, J. M., et al. "Salvage brachytherapy for local recurrence of cancer after definitive irradiation: a GEC-ESTRO narrative review." Radiotherapy and Oncology 209 (2025).
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