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Dose Accumulation for Pelvic Stereotactic Ablative Radiotherapy Reirradiation.

F Slevin¹, C O'Hara², J Entwisle²

¹Leeds Institute of Medical Research, University of Leeds, Leeds, LS9 7TF, UK; Department of Clinical Oncology, Leeds Teaching Hospitals NHS Trust, Beckett Street, Leeds, LS9 7TF, UK.

Clinical Oncology (Royal College of Radiologists (Great Britain))

|May 28, 2025

Summary

This summary is machine-generated.

This study evaluated cumulative radiation doses in patients receiving pelvic stereotactic ablative radiotherapy (SABR) reirradiation. No severe toxicity was observed, suggesting feasibility of advanced dose evaluation methods.

Keywords:

Dose accumulation image registration pelvic cancer reirradiation stereotactic ablative radiotherapy stereotactic body radiotherapy

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Area of Science:

Radiation Oncology
Medical Physics
Oncology

Background:

Normal tissue dose constraints for reirradiation are not well-established.
Accurate cumulative dose evaluation is challenging due to anatomical changes and fraction size.

Purpose of the Study:

To retrospectively evaluate cumulative normal tissue doses in pelvic stereotactic ablative radiotherapy (SABR) reirradiation.
To assess the feasibility of advanced dose evaluation methods and gather preliminary data on safe cumulative doses.

Main Methods:

Retrospective analysis of 56 patients undergoing pelvic SABR reirradiation.
Deformable image registration (DIR) to transfer original dose distributions to reirradiation CT scans.
Calculation of cumulative doses in equivalent dose in 2-Gy fractions (EQD2) and summed maximum doses (D0.5 cc).

Main Results:

Cumulative doses up to 82.8 Gy (rectum), 110.2 Gy (bladder), 69.8 Gy (colon), 101.4 Gy (sacral plexus), and 108.1 Gy (vessels) were observed.
Small bowel received cumulative doses up to 111.9 Gy (D0.5 cc).
No severe toxicity events were attributed to reirradiation or cumulative doses.

Conclusions:

Demonstrated feasibility of 3D evaluation of cumulative normal tissue doses in pelvic SABR reirradiation.
Preliminary data suggest no observed toxicity related to delivered cumulative or reirradiation doses.