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Re-Irradiation Imaging, Planning and Biology

M Feng1*, M Matuszak2*, A Jackson3*, M Milosevic4*, A Appelt5*, (1) University of California San Francisco, San Francisco, CA, (2) University of Michigan, Ann Arbor, MI, (3) Memorial Sloan-Kettering Cancer Center, New York, NY, (4) Princess Margaret Cancer Centre and University Health Network, Toronto, ON, CA, (5) St James's University Hospital & University of Leeds, Leeds, West Yorkshire, GB


(Thursday, 7/16/2020) 1:00 PM - 3:00 PM [Eastern Time (GMT-4)]

Room: Track 3

Re-irradiation is becoming commonplace in academic and community radiation oncology clinics around the world. In many cases, medical physicists are playing a key role in the determination of appropriate re-irradiation doses and planning strategies. It is crucial that medical physicists understand the knowledge factors associated with participating in re-irradiation consults and contribute to standardization in this area when possible. In this session, we will review the literature on re-irradiation and the scope and limitations of our clinical, physics, and radiobiological knowledge of retreatment with radiation therapy across a range of body sites. Next, we will discuss the current strategies being employed for treatment planning in re-irradiation cases as well as the approach for medical physics evaluation and consults as part of a routine clinical workflow. We will provide an overview of the radiation biology concepts behind re-irradiation and what evidence can be used to justify different radiobiological corrections for various retreatment scenarios. Finally, we will discuss approaches to re-irradiation across the world, specifically the Pan-Canadian and UK strategies for radiotherapy retreatment case evaluation, consult, and overall goals.

Learning Objectives:
1. What are the range of approaches that clinics are using to design dose limits in re-irradiation?
2. How are clinics using special medical physics consults to quantify combined dose measures?
3. What are the biological effects that need to be considered in toxicity models for re-irradiation?



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