ArticleActa oncologica (Stockholm, Sweden)2025
Clinical workflow for reirradiation: national consensus recommendations on imaging, treatment planning, dose accumulation, and treatment delivery.
Article in Acta oncologica (Stockholm, Sweden), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Reirradiation of lower gastrointestinal Cancer: A survey of ongoing trials by the Reirradiation Collaborative group (ReCOG).Technical innovations & patient support in radiation oncology · 2026Article
- A dedicated institutional clinical workflow and peer-review meeting for reirradiation.Technical innovations & patient support in radiation oncology · 2026Article
- Isotoxic stereotactic reirradiation for recurrent pelvic cancers.Physics and imaging in radiation oncology · 2026Article
- Multi-institutional virtual peer review for reirradiation: dedicated workflow and one-year results.Technical innovations & patient support in radiation oncology · 2025Article
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Authors and funding
13 authors.
Funding
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Abstract
background and purposeReirradiation is becoming more frequent in clinical practice. However, workflows and practices vary widely between clinics, as general guidelines are scarce or lacking in practical detail. This paper presents comprehensive national Danish consensus recommendations covering all steps of the reirradiation workflow. The aim is to standardise and improve reirradiation treatment quality and provide guidance for much-needed large-scale clinical trials.
methodsAn expert panel was formed comprising physicians, clinical physicists, and clinical researchers from all Danish radiotherapy centres. An in-person 2-day workshop was followed by multiple online meetings. Recommendations were based on expert consensus, supported by review of existing literature, and were reviewed by all Danish Multidisciplinary Cancer Groups before publication.
resultsReirradiation cases should be designated clearly as such at each workflow step. Review of patient cases at multidisciplinary reirradiation conferences is encouraged. Immobilisation, positioning, and motion management should resemble that of previous treatment(s) as closely as possible. Information on previous dose should be used in planning and evaluation. The degree of complexity (e.g. summation of dose maxima, rigid/deformable image registration, 3D dose accumulation) should reflect the clinical situation as well as the extent/quality of available information. Dose should always be converted to an equieffective dose before summation. Daily image-guidance and regular evaluation of delivered dose are recommended. We provide guidance on quality assurance of dose mapping and guidelines for clinical reirradiation trials.
interpretationWe present national consensus guidelines for site-independent reirradiation treatment workflows. The guidelines have been approved by the site-specific Danish Multidisciplinary Cancer Groups.
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