ArticleClinical and translational radiation oncology2019
Definitive hyperfractionated, accelerated proton reirradiation for patients with pelvic malignancies.
Article in Clinical and translational radiation oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06397573 (Phase 1 Trial of Ablative Stereotactic MR-Guided Adaptive Reirradiation for Abdominal and Pelvic Tumors), which is not on this map. Cited by 21 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Phase 1 Trial of Ablative Stereotactic MR-Guided Adaptive Reirradiation for Abdominal and Pelvic Tumors
Who cites it
21 citing papers in PubMed, 3 syntheses or guidelines pooled it, 28 citations in OpenAlex.
- The role of particle therapy in the treatment of locally recurrent rectal cancer: a systematic review.Radiology and oncology · 2026Pooled it
- Spanish Society for Radiation Oncology and Spanish Society of Medical Physicists recommendations on reirradiation in gynecological cancer: reirradiation techniques, survival outcomes, dose, and toxicity.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Guideline
- Evaluating the Effectiveness of Proton Beam Therapy Compared to Conventional Radiotherapy in Non-Metastatic Rectal Cancer: A Systematic Review of Clinical Outcomes.Medicina (Kaunas, Lithuania) · 2024Pooled it
- Innovative radiotherapy approaches.ESMO gastrointestinal oncology · 2026Review
- Particle Therapy Co-Operative Group Consensus Statement on Reirradiation With Proton Therapy for Prostate Cancer.International journal of particle therapy · 2026Article
- Review
- Acute toxicity and quality of life in dose-escalated proton reirradiation for locally recurrent rectal cancer: The prospective ReRad II trial.Clinical and translational radiation oncology · 2025Review
- Radiotherapy & total neoadjuvant therapy for recurrent rectal cancer in previously irradiated patients, (RETRY): a multicenter prospective observational study.Radiation oncology (London, England) · 2024Observational
- Inter-fraction motion robustness in a prospective phase II trial on dose-escalated proton reirradiation for locally recurrent rectal cancer.Physics and imaging in radiation oncology · 2024Article
- Proton beam reirradiation for locally recurrent rectal cancer patients with prior pelvic irradiation.Journal of radiation research · 2024Article
- PTCOG Gastrointestinal Subcommittee Lower Gastrointestinal Tract Malignancies Consensus Statement.International journal of particle therapy · 2024Review
- Factors Associated With and Characteristics of Patients Receiving Proton Therapy at the End of Life.International journal of particle therapy · 2024Article
- Preoperative short-course radiation therapy with PROtons compared to photons in high-risk RECTal cancer (PRORECT): Initial dosimetric experience.Clinical and translational radiation oncology · 2023Article
- Proton Therapy in the Management of Luminal Gastrointestinal Cancers: Esophagus, Stomach, and Anorectum.Cancers · 2022Review
- A treatment planning comparison of photon stereotactic ablative radiotherapy and proton beam therapy for the re-irradiation of pelvic cancer recurrence.Physics and imaging in radiation oncology · 2022Article
- Proton Reirradiation: Expert Recommendations for Reducing Toxicities and Offering New Chances of Cure in Patients With Challenging Recurrence Malignancies.Seminars in radiation oncology · 2020Review
- Clinical Outcomes of Intensity Modulated Proton Therapy Reirradiation for Gynecologic Malignancies.Advances in radiation oncologyArticle
- Dose-Escalated Magnetic Resonance Image-Guided Abdominopelvic Reirradiation With Continuous Intrafraction Visualization, Soft Tissue Tracking, and Automatic Beam Gating.Advances in radiation oncologyArticle
- Reirradiation for Rectal Cancer Using Pencil Beam Scanning Proton Therapy: A Single Institutional Experience.Advances in radiation oncologyArticle
- Reirradiation: Standards, challenges, and patient-focused strategies across tumor types.CA: a cancer journal for cliniciansReview
Corrections and comments
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Authors and funding
14 authors at 2 institutions in 1 country.
Funding
Abstract
introductionPelvic reirradiation (re-RT) presents challenges due to concerns for late toxicity to tissues-at-risk including pelvic bone marrow (PBM). We routinely utilize a hyperfractionated, accelerated re-RT for recurrent rectal or anal cancer in the setting of prior radiation. We hypothesized that proton beam radiation (PBR) is uniquely suited to limit doses to pelvic non-target tissues better than photon-based approaches. MATERIALS AND
methodsAll patients who received hyperfractionated, accelerated PBR re-RT to the pelvis from 2007 to 2017 were identified. Re-RT was delivered twice daily with a 6 h minimum interfraction interval at 1.5 Gray Relative Biological Effectiveness (Gy(RBE)) per fraction to a total dose of 39-45 Gy(RBE). Concurrent chemotherapy was given to all patients. Comparison photon plans were generated for dosimetric analysis. Dosimetric parameters compared using a matched-pair analysis and the Wilcoxon signed-rank test. Survival analysis was performed Kaplan Meier curves.
resultsFifteen patients were identified, with a median prior pelvic RT dose of 50.4 Gy (range 25-80 Gy). Median time between the initial RT and PBRT re-RT was 4.7 years (range 1.0-36.1 years). In comparison to corresponding photon re-RT plans, PBR re-RT plans had lower mean PBM dose, and lower volume of PBM getting 5 Gy, 10 Gy, 20 Gy, and 30 Gy (p < 0.001, p < 0.001, p < 0.001, and p = 0.033, respectively).With median 13.9 months follow-up after PBR re-RT, five patients had developed local recurrences, and four patients had developed distant metastases. One-year overall survival following PBR re-RT was 67.5% and one-year progression free survival was 58.7%. No patients developed acute or late Grade 4 toxicity.
conclusionPBR re-RT affords improved sparing of PBM compared with photon-based re-RT. Clinically, PBR re-RT is well-tolerated. However, given modest control rates with definitive re-RT without subsequent surgical resection, a multidisciplinary approach should be favored in this setting when feasible.
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