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Area of Science:

  • Medical Physics
  • Radiation Oncology
  • Radiotherapy

Background:

  • Reirradiation (reRT) requires careful dosimetric assessment to ensure patient safety.
  • Standardized methods for cumulative dose evaluation in reRT are essential for clinical practice.

Purpose of the Study:

  • To provide a practical, case-based example for reirradiation (reRT) evaluation.
  • To demonstrate step-by-step calculations and documentation for reRT dosimetric assessment.
  • To illustrate the application of the Reirradiation Collaborative Group (ReCOG) consensus in clinical practice.

Main Methods:

  • Two spine reirradiation cases were analyzed.
  • Cumulative organ-at-risk (OAR) doses were assessed using direct point dose summation, summation within overlap regions, and image registration-based 3D dose summation.
  • New dose objectives for subsequent planning iterations were derived and compared.

Main Results:

  • Different cumulative dose estimation strategies were detailed, considering the availability of equieffective dose calculation tools.
  • The selection of an assessment strategy should balance clinical resources with patient-specific needs.
  • Manual determination of overlapping doses can improve accuracy when 3D equieffective dose calculation is unavailable.

Conclusions:

  • Case examples illustrate the application of the ReCOG consensus for reRT dosimetric assessment and reporting.
  • Multiple strategies for cumulative dose evaluation were demonstrated.
  • This work supports enhanced patient care and safer reirradiation delivery.