TY - JOUR
T1 - Ongoing prospective studies on reirradiation
T2 - A systematic review of a clinical trials database
AU - Willmann, Jonas
AU - Balermpas, Panagiotis
AU - Rimner, Andreas
AU - Appelt, Ane L.
AU - Vasquez Osorio, Eliana Maria
AU - Rønde, Heidi S.
AU - Day, Madalyne
AU - Embring, Anna
AU - Gabryś, Dorota
AU - Guren, Marianne G.
AU - Hoskin, Peter
AU - Massaccesi, Mariangela
AU - Mayo, Charles
AU - Murray, Louise
AU - Nieder, Carsten
AU - Guckenberger, Matthias
AU - Andratschke, Nicolaus
N1 - Publisher Copyright:
© 2024 The Author(s)
PY - 2025/1/1
Y1 - 2025/1/1
N2 - Introduction: Reirradiation has gained increasing interest, as advances in systemic therapy increase the survival of patients with cancer, and modern radiation techniques allow more precise treatments. However, high-quality prospective evidence on the safety and efficacy of reirradiation to guide clinical practice remains scarce. This systematic review evaluates ongoing prospective studies on reirradiation to identify research gaps and priorities. Methods: A systematic review of ClinicalTrials.gov was conducted on July 11, 2024, using search terms related to reirradiation. Inclusion criteria were prospective studies that were “recruiting,” “not yet recruiting,” or “active, not recruiting.” Studies with published results, retrospective, and in-silico studies were excluded. The review followed PRISMA 2020 guidelines and recommendations for systematic searches of clinical trial registries. Results: Among 1026 identified studies, 307 were screened, 99 were included. Fourty (40%) focused on central nervous system (CNS), 23 (23%) head and neck, and 17 (17%) on pelvic reirradiation. Most studies (90%) were interventional, with 32 (32%) phase II and 4 (4%) phase III trials. Sixteen trials were randomized (RCTs), including the 4 phase III trials for recurrent glioblastoma, rectal and nasopharyngeal cancer. Ten dose escalation trials focus on recurrent prostate, rectal, and non-small cell lung cancer as well as glioma. Modern high-precision radiotherapy techniques were frequently used, with 21 (21%) studies using stereotactic radiotherapy and 17 (17%) using particle therapy. Combinations with systemic therapies were investigated in 41 (41%) studies. Conclusion: Ongoing studies most frequently focus on CNS, head and neck, and pelvic reirradiation. There remains a critical need for RCTs, in particular for lung, breast, and gynecological cancers. Dose escalation trials, application of precision radiation techniques and combinations with modern systemic therapy may help define the optimal multimodality treatment schedules.
AB - Introduction: Reirradiation has gained increasing interest, as advances in systemic therapy increase the survival of patients with cancer, and modern radiation techniques allow more precise treatments. However, high-quality prospective evidence on the safety and efficacy of reirradiation to guide clinical practice remains scarce. This systematic review evaluates ongoing prospective studies on reirradiation to identify research gaps and priorities. Methods: A systematic review of ClinicalTrials.gov was conducted on July 11, 2024, using search terms related to reirradiation. Inclusion criteria were prospective studies that were “recruiting,” “not yet recruiting,” or “active, not recruiting.” Studies with published results, retrospective, and in-silico studies were excluded. The review followed PRISMA 2020 guidelines and recommendations for systematic searches of clinical trial registries. Results: Among 1026 identified studies, 307 were screened, 99 were included. Fourty (40%) focused on central nervous system (CNS), 23 (23%) head and neck, and 17 (17%) on pelvic reirradiation. Most studies (90%) were interventional, with 32 (32%) phase II and 4 (4%) phase III trials. Sixteen trials were randomized (RCTs), including the 4 phase III trials for recurrent glioblastoma, rectal and nasopharyngeal cancer. Ten dose escalation trials focus on recurrent prostate, rectal, and non-small cell lung cancer as well as glioma. Modern high-precision radiotherapy techniques were frequently used, with 21 (21%) studies using stereotactic radiotherapy and 17 (17%) using particle therapy. Combinations with systemic therapies were investigated in 41 (41%) studies. Conclusion: Ongoing studies most frequently focus on CNS, head and neck, and pelvic reirradiation. There remains a critical need for RCTs, in particular for lung, breast, and gynecological cancers. Dose escalation trials, application of precision radiation techniques and combinations with modern systemic therapy may help define the optimal multimodality treatment schedules.
KW - Clinical Trials
KW - Dose escalation trials
KW - Randomized controlled trials
KW - Reirradiation
KW - Systematic review
UR - http://www.scopus.com/inward/record.url?scp=85208966409&partnerID=8YFLogxK
U2 - 10.1016/j.radonc.2024.110624
DO - 10.1016/j.radonc.2024.110624
M3 - Article
C2 - 39532233
AN - SCOPUS:85208966409
SN - 0167-8140
VL - 202
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
M1 - 110624
ER -
