{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T04:15:05Z","timestamp":1792124105076,"version":"4.4.0"},"reference-count":118,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","thegreenjournal.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Radiotherapy and Oncology"],"published-print":{"date-parts":[[2026,10]]},"DOI":"10.1016\/j.radonc.2026.111647","type":"journal-article","created":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T15:42:56Z","timestamp":1782574976000},"page":"111647","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":3,"special_numbering":"C","title":["ESTRO recommendations for the use, planning and delivery of reirradiation in locally recurrent rectal cancer \u2013 Endorsed by ASTRO"],"prefix":"10.1016","volume":"223","author":[{"given":"Heike M.U.","family":"Peulen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi S.","family":"R\u00f8nde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9783-4340","authenticated-orcid":false,"given":"Camilla","family":"Kronborg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacobus W.A.","family":"Burger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aileen","family":"Duffton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0593-0218","authenticated-orcid":false,"given":"Marianne G.","family":"Guren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5323-5696","authenticated-orcid":false,"given":"Sun","family":"Myint","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9905-5866","authenticated-orcid":false,"given":"Joost","family":"Nederend","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Floor","family":"Piqeur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7281-0991","authenticated-orcid":false,"given":"Alexander","family":"Valdman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ane L.","family":"Appelt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Muirhead","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.radonc.2026.111647_b0005","doi-asserted-by":"crossref","first-page":"2059","DOI":"10.1016\/j.ejso.2019.06.016","article-title":"Treatment and survival of locally recurrent rectal cancer: a cross-sectional population study 15 years after the Dutch TME trial","volume":"45","author":"Detering","year":"2019","journal-title":"Eur J Surg Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0010","doi-asserted-by":"crossref","first-page":"5194","DOI":"10.1245\/s10434-021-10070-6","article-title":"Re-irradiation in patients with recurrent rectal cancer is safe and feasible","volume":"28","author":"Dijkstra","year":"2021","journal-title":"Ann Surg Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0015","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1002\/jso.23023","article-title":"Reirradiation to the pelvis for recurrent rectal cancer","volume":"105","author":"Koom","year":"2012","journal-title":"J Surg Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0020","doi-asserted-by":"crossref","first-page":"529","DOI":"10.3389\/fonc.2019.00529","article-title":"Treatment outcomes of re-irradiation in locoregionally recurrent rectal cancer and clinical significance of proper patient selection","volume":"9","author":"Chung","year":"2019","journal-title":"Front Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0025","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/j.ijrobp.2025.01.038","article-title":"Joining forces to advance reirradiation: establishing the reirradiation collaborative group (ReCOG)","volume":"122","author":"Mayo","year":"2025","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.radonc.2026.111647_b0030","doi-asserted-by":"crossref","DOI":"10.1016\/j.radonc.2023.109947","article-title":"Re-irradiation in clinical practice: results of an international patterns of care survey within the framework of the ESTRO-EORTC E(2)-RADIatE platform","volume":"189","author":"Willmann","year":"2023","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0035","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1097\/SLA.0000000000002528","article-title":"Surgical and survival outcomes following pelvic exenteration for locally advanced primary rectal cancer: results from an international collaboration","volume":"269","author":"PelvEx","year":"2019","journal-title":"Ann Surg"},{"key":"10.1016\/j.radonc.2026.111647_b0040","doi-asserted-by":"crossref","first-page":"1457","DOI":"10.1111\/j.1463-1318.2012.03005.x","article-title":"Meta-analysis of survival based on resection margin status following surgery for recurrent rectal cancer","volume":"14","author":"Bhangu","year":"2012","journal-title":"Colorectal Dis"},{"key":"10.1016\/j.radonc.2026.111647_b0045","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1002\/bjs.10734","article-title":"Factors affecting outcomes following pelvic exenteration for locally recurrent rectal cancer","volume":"105","author":"PelvEx","year":"2018","journal-title":"Br J Surg"},{"key":"10.1016\/j.radonc.2026.111647_b0050","unstructured":"National Comprehensive Cancer Network. NCCN Guidelines Rectal Cancer Version 2.2025 [Accessed 09\/08\/2025]. Available from [https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/rectal.pdf]."},{"key":"10.1016\/j.radonc.2026.111647_b0055","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1016\/j.ejso.2016.01.007","article-title":"Systematic review of health-related quality of life in patients undergoing pelvic exenteration","volume":"42","author":"Harji","year":"2016","journal-title":"Eur J Surg Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0060","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.1002\/bjs.9569","article-title":"Feasibility of reirradiation in the treatment of locally recurrent rectal cancer","volume":"101","author":"Bosman","year":"2014","journal-title":"Br J Surg"},{"key":"10.1016\/j.radonc.2026.111647_b0065","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.ejso.2016.08.015","article-title":"Results of a pooled analysis of IOERT containing multimodality treatment for locally recurrent rectal cancer: results of 565 patients of two major treatment centres","volume":"43","author":"Holman","year":"2017","journal-title":"Eur J Surg Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0070","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.1016\/j.ijrobp.2005.09.017","article-title":"Preoperative hyperfractionated chemoradiation for locally recurrent rectal cancer in patients previously irradiated to the pelvis: a multicentric phase II study","volume":"64","author":"Valentini","year":"2006","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.radonc.2026.111647_b0075","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1016\/j.ejso.2019.10.037","article-title":"Locally recurrent rectal cancer; long-term outcome of curative surgical and non-surgical treatment of 447 consecutive patients in a tertiary referral centre","volume":"46","author":"Hagemans","year":"2020","journal-title":"Eur J Surg Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0080","doi-asserted-by":"crossref","first-page":"e230","DOI":"10.1111\/j.1463-1318.2011.02895.x","article-title":"Local recurrence of rectal cancer: a population-based cohort study of diagnosis, treatment and outcome","volume":"14","author":"Kodeda","year":"2012","journal-title":"Colorectal Dis"},{"key":"10.1016\/j.radonc.2026.111647_b0085","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.radonc.2019.05.021","article-title":"Practical effectiveness of re-irradiation with or without surgery for locoregional recurrence of rectal cancer: a meta-analysis and systematic review","volume":"140","author":"Lee","year":"2019","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0090","doi-asserted-by":"crossref","DOI":"10.1016\/j.ejso.2023.03.005","article-title":"Locally recurrent rectal cancer and distant metastases: is there still a chance of cure?","volume":"49","author":"van Rees","year":"2023","journal-title":"Eur J Surg Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0095","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1053\/ejso.2001.1115","article-title":"The impact of recurrent rectal cancer on quality of life","volume":"27","author":"Camilleri-Brennan","year":"2001","journal-title":"Eur J Surg Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0100","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1097\/DCR.0000000000000403","article-title":"Effect of surgery on health-related quality of life of patients with locally recurrent rectal cancer","volume":"58","author":"Pellino","year":"2015","journal-title":"Dis Colon Rectum"},{"key":"10.1016\/j.radonc.2026.111647_b0105","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.radonc.2021.06.030","article-title":"A multicentre retrospective review of SABR reirradiation in rectal cancer recurrence","volume":"162","author":"Johnstone","year":"2021","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0110","article-title":"Contemporary management of locally advanced and recurrent rectal cancer: views from the PelvEx collaborative","volume":"14","author":"PelvEx","year":"2022","journal-title":"Cancers (Basel)"},{"key":"10.1016\/j.radonc.2026.111647_b0115","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1002\/bjs.9192","article-title":"Consensus statement on the multidisciplinary management of patients with recurrent and primary rectal cancer beyond total mesorectal excision planes","volume":"100","author":"Beyond","year":"2013","journal-title":"Br J Surg"},{"key":"10.1016\/j.radonc.2026.111647_b0120","doi-asserted-by":"crossref","unstructured":"Glynne-Jones R, Wyrwicz L, Tiret E, Brown G, Rodel C, Cervantes A, et al. Rectal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2017;28(suppl_4):iv22-iv40.","DOI":"10.1093\/annonc\/mdx224"},{"key":"10.1016\/j.radonc.2026.111647_b0125","doi-asserted-by":"crossref","DOI":"10.1016\/j.annonc.2025.05.528","article-title":"Localised rectal cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up","author":"Hofheinz","year":"2025","journal-title":"Ann Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0130","first-page":"41","article-title":"ESTRO\/ACROP IORT recommendations for intraoperative radiation therapy in locally recurrent rectal cancer","volume":"24","author":"Calvo","year":"2020","journal-title":"Clin Transl Radiat Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0135","doi-asserted-by":"crossref","DOI":"10.1016\/j.radonc.2025.110979","article-title":"Salvage brachytherapy for local recurrence of cancer after definitive irradiation: a GEC-ESTRO narrative review","volume":"209","author":"Hannoun-Levi","year":"2025","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0140","doi-asserted-by":"crossref","first-page":"1909","DOI":"10.1111\/codi.15670","article-title":"A phase III randomized trial evaluating chemotherapy followed by pelvic reirradiation versus chemotherapy alone as preoperative treatment for locally recurrent rectal cancer - GRECCAR 15 trial protocol","volume":"23","author":"Denost","year":"2021","journal-title":"Colorectal Dis"},{"key":"10.1016\/j.radonc.2026.111647_b0145","doi-asserted-by":"crossref","DOI":"10.3389\/fonc.2023.1304767","article-title":"TORCH-R trial protocol: hypofractionated radiotherapy combined with chemotherapy and toripalimab for locally recurrent rectal cancer: a prospective, single-arm, two-cohort, phase II trial","volume":"13","author":"Wan","year":"2023","journal-title":"Front Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0150","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1186\/s13014-024-02555-x","article-title":"Radiotherapy & total neoadjuvant therapy for recurrent rectal cancer in previously irradiated patients, (RETRY): a multicenter prospective observational study","volume":"19","author":"Gambacorta","year":"2024","journal-title":"Radiat Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0155","doi-asserted-by":"crossref","unstructured":"Moreno-Olmedo E, Owczarczyk K, Chadwick E, Dickinson P, Duffton A, Jones B, et al. Pelvic stereotactic ablative body radiotherapy (SABR) reirradiation: UK SABR consortium guidance for use in routine clinical care. Technical Innovations & Patient Support in Radiation Oncology. 2025;35.","DOI":"10.1016\/j.tipsro.2025.100326"},{"key":"10.1016\/j.radonc.2026.111647_b0160","doi-asserted-by":"crossref","DOI":"10.1016\/j.radonc.2024.110624","article-title":"Ongoing prospective studies on reirradiation: a systematic review of a clinical trials database","volume":"202","author":"Willmann","year":"2025","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0165","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/j.radonc.2022.11.008","article-title":"Development of a consensus-based delineation guideline for locally recurrent rectal cancer","volume":"177","author":"Piqeur","year":"2022","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0170","doi-asserted-by":"crossref","first-page":"e166","DOI":"10.1016\/j.prro.2024.11.008","article-title":"Reirradiation in the management of locally recurrent rectal adenocarcinoma","volume":"15","author":"Rutenberg","year":"2025","journal-title":"Pract Radiat Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0175","unstructured":"European Society for Radiotherapy & Oncology (ESTRO). Guidelines Committee Procedures Policy Version 3. 2024 [Accessed 09\/08\/2025]. Available from [https:\/\/www.estro.org\/ESTRO\/media\/ESTRO\/Science\/Guidelines\/Guidelines-Committee-SOP_Sept-2024.pdf]."},{"key":"10.1016\/j.radonc.2026.111647_b0180","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"10.1016\/j.radonc.2026.111647_b0185","doi-asserted-by":"crossref","first-page":"e469","DOI":"10.1016\/S1470-2045(22)00447-8","article-title":"European Society for Radiotherapy and Oncology and European Organisation for Research and Treatment of Cancer consensus on re-irradiation: definition, reporting, and clinical decision making","volume":"23","author":"Andratschke","year":"2022","journal-title":"Lancet Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0190","unstructured":"Patton C, Bradfield L. ASTRO Methodology Guide - Version 1. [Accessed 09\/08\/2025]. Available from [https:\/\/wwwastroorg\/ASTRO\/media\/ASTRO\/Patient%20Care%20and%20Research\/PDFs\/ASTRO_GuidelineMethodologypdf]. 2019."},{"key":"10.1016\/j.radonc.2026.111647_b0195","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1053\/srao.2000.6593","article-title":"Tissue tolerance to reirradiation","volume":"10","author":"Nieder","year":"2000","journal-title":"Sem Radiat Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0200","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.clon.2017.11.014","article-title":"The principles and practice of re-irradiation in clinical oncology: an overview","volume":"30","author":"Dorr","year":"2018","journal-title":"Clin Oncol (R Coll Radiol)"},{"key":"10.1016\/j.radonc.2026.111647_b0205","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1016\/j.radonc.2014.04.018","article-title":"High-dose reirradiation with intensity-modulated radiotherapy for recurrent head-and-neck cancer: disease control, survival and toxicity","volume":"111","author":"Duprez","year":"2014","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0210","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1002\/hed.24733","article-title":"Reirradiation of head and neck cancer: long-term disease control and toxicity","volume":"39","author":"Bots","year":"2017","journal-title":"Head Neck"},{"key":"10.1016\/j.radonc.2026.111647_b0215","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1016\/j.ijrobp.2016.03.015","article-title":"Reirradiation of head and neck cancers with intensity modulated radiation therapy: outcomes and analyses","volume":"95","author":"Takiar","year":"2016","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.radonc.2026.111647_b0220","doi-asserted-by":"crossref","first-page":"2429","DOI":"10.1016\/j.ejso.2021.05.017","article-title":"Improved response rate in patients with prognostically poor locally advanced rectal cancer after treatment with induction chemotherapy and chemoradiotherapy when compared with chemoradiotherapy alone: a matched case-control study","volume":"47","author":"Voogt;","year":"2021","journal-title":"Eur J Surg Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0225","doi-asserted-by":"crossref","first-page":"3609","DOI":"10.1245\/s10434-016-5250-z","article-title":"The use of Re-irradiation in locally recurrent, non-metastatic rectal cancer","volume":"23","author":"Susko","year":"2016","journal-title":"Ann Surg Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0230","doi-asserted-by":"crossref","first-page":"1759","DOI":"10.1002\/cncr.11719","article-title":"Reirradiation and hyperthermia in rectal carcinoma: a retrospective study on palliative effect","volume":"98","author":"Juffermans","year":"2003","journal-title":"Cancer"},{"key":"10.1016\/j.radonc.2026.111647_b0235","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1186\/s13014-014-0278-3","article-title":"Accelerated hyperfractionated intensity-modulated radiotherapy for recurrent\/unresectable rectal cancer in patients with previous pelvic irradiation: results of a phase II study","volume":"9","author":"Cai","year":"2014","journal-title":"Radiat Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0240","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.radonc.2016.12.015","article-title":"Hyperfractionated accelerated reirradiation for rectal cancer: an analysis of outcomes and toxicity","volume":"122","author":"Tao","year":"2017","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0245","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1016\/S0360-3016(97)00058-8","article-title":"Palliative reirradiation for recurrent rectal cancer","volume":"38","author":"Lingareddy","year":"1997","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.radonc.2026.111647_b0250","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1111\/1754-9485.12057","article-title":"Once-daily reirradiation for rectal cancer in patients who have received previous pelvic radiotherapy","volume":"57","author":"Ng","year":"2013","journal-title":"J Med Imaging Radiat Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0255","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1016\/S0360-3016(00)01528-5","article-title":"Intraoperative irradiation for locally recurrent colorectal cancer in previously irradiated patients","volume":"49","author":"Haddock","year":"2001","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.radonc.2026.111647_b0260","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1002\/jso.21737","article-title":"The role of omental flap transposition in patients with locoregional recurrent rectal cancer treated with reirradiation","volume":"102","author":"Kim","year":"2010","journal-title":"J Surg Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0265","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1259\/bjr\/28173562","article-title":"Accelerated hyperfractionation field-involved re-irradiation combined with concurrent capecitabine chemotherapy for locally recurrent and irresectable rectal cancer","volume":"85","author":"Sun","year":"2012","journal-title":"Br J Radiol"},{"key":"10.1016\/j.radonc.2026.111647_b0270","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1002\/cncr.10799","article-title":"Long-term results of reirradiation for patients with recurrent rectal carcinoma","volume":"95","author":"Mohiuddin","year":"2002","journal-title":"Cancer"},{"key":"10.1016\/j.radonc.2026.111647_b0275","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1007\/s00066-008-1731-8","article-title":"Radiochemotherapy in combination with regional hyperthermia in preirradiated patients with recurrent rectal cancer","volume":"184","author":"Milani","year":"2008","journal-title":"Strahlenther Onkol"},{"key":"10.1016\/j.radonc.2026.111647_b0280","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.ijrobp.2009.04.056","article-title":"Hyperfractionated accelerated radiotherapy for rectal cancer in patients with prior pelvic irradiation","volume":"77","author":"Das","year":"2010","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.radonc.2026.111647_b0285","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.adro.2016.02.002","article-title":"Efficacy and toxicity of rectal cancer reirradiation using IMRT for patients who have received prior pelvic radiation therapy","volume":"1","author":"Youssef","year":"2016","journal-title":"Adv Radiat Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0290","article-title":"Re-irradiation for recurrent rectal cancer - a single-center experience","volume":"1\u20137","author":"Al-Haidari","year":"2020","journal-title":"Acta Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0295","doi-asserted-by":"crossref","first-page":"1937","DOI":"10.1245\/s10434-008-9896-z","article-title":"Radical resection after IORT-containing multimodality treatment is the most important determinant for outcome in patients treated for locally recurrent rectal cancer","volume":"15","author":"Dresen","year":"2008","journal-title":"Ann Surg Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0300","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/j.radonc.2008.02.021","article-title":"Reirradiation, surgery and IORT for recurrent rectal cancer in previously irradiated patients","volume":"87","author":"Vermaas","year":"2008","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0305","doi-asserted-by":"crossref","DOI":"10.1259\/bjr.20180794","article-title":"Results of re-irradiation for pelvic recurrence in anorectal cancer patients","volume":"92","author":"Park","year":"2019","journal-title":"Br J Radiol"},{"key":"10.1016\/j.radonc.2026.111647_b0310","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/j.radonc.2014.11.021","article-title":"Reirradiation of locally recurrent rectal cancer: a systematic review","volume":"113","author":"Guren","year":"2014","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0315","doi-asserted-by":"crossref","first-page":"3503","DOI":"10.1245\/s10434-020-08362-4","article-title":"Improved outcomes for responders after treatment with induction chemotherapy and chemo(re)irradiation for locally recurrent rectal cancer","volume":"27","author":"Voogt;","year":"2020","journal-title":"Ann Surg Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0320","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1016\/j.adro.2020.07.017","article-title":"Stereotactic body radiation therapy reirradiation for locally recurrent rectal cancer: outcomes and toxicity","volume":"5","author":"Smith","year":"2020","journal-title":"Adv Radiat Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0325","doi-asserted-by":"crossref","first-page":"408","DOI":"10.4103\/0973-1482.92000","article-title":"Stereotactic body radiothearpy for the treatment of presacral recurrences from rectal cancers","volume":"7","author":"DeFoe","year":"2011","journal-title":"J Cancer Res Ther"},{"key":"10.1016\/j.radonc.2026.111647_b0330","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.radonc.2017.09.030","article-title":"Pelvic re-irradiation using stereotactic ablative radiotherapy (SABR): a systematic review","volume":"125","author":"Murray","year":"2017","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0335","article-title":"Stereotactic reirradiation: final results from a phase 1 dose escalation trial (DESTROY-1)","author":"Deodato","year":"2025","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.radonc.2026.111647_b0340","doi-asserted-by":"crossref","first-page":"2","DOI":"10.14338\/IJPT.13-00002.1","article-title":"Proton reirradiation of recurrent rectal cancer: dosimetric comparison, toxicities, and preliminary outcomes","volume":"1","author":"Berman","year":"2014","journal-title":"Int. J. Particle Ther."},{"key":"10.1016\/j.radonc.2026.111647_b0345","doi-asserted-by":"crossref","first-page":"3589","DOI":"10.21873\/anticanres.15147","article-title":"Proton beam therapy for local recurrence of rectal cancer","volume":"41","author":"Hiroshima","year":"2021","journal-title":"Anticancer Res"},{"key":"10.1016\/j.radonc.2026.111647_b0350","article-title":"Reirradiation for rectal cancer using pencil beam scanning proton therapy: a single institutional experience","volume":"6","author":"Koroulakis","year":"2021","journal-title":"Adv Radiat Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0355","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1093\/jrr\/rrae019","article-title":"Proton beam reirradiation for locally recurrent rectal cancer patients with prior pelvic irradiation","volume":"65","author":"Takagawa","year":"2024","journal-title":"J Radiat Res"},{"key":"10.1016\/j.radonc.2026.111647_b0360","article-title":"Outcomes and prognostic factors for locally recurrent rectal cancer treated with proton beam therapy","volume":"8","author":"Takagawa","year":"2023","journal-title":"Adv Radiat Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0365","first-page":"59","article-title":"Definitive hyperfractionated, accelerated proton reirradiation for patients with pelvic malignancies","volume":"19","author":"Moningi","year":"2019","journal-title":"Clin Transl Radiat Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0370","article-title":"Acute toxicity and quality of life in dose-escalated proton reirradiation for locally recurrent rectal cancer: the prospective ReRad II trial","volume":"54","author":"Truelsen","year":"2025","journal-title":"Clin Transl Radiat Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0375","doi-asserted-by":"crossref","first-page":"1547","DOI":"10.21873\/invivo.11944","article-title":"Re-irradiation with carbon ion radiotherapy for pelvic rectal cancer recurrences in patients previously irradiated to the pelvis","volume":"34","author":"Barcellini","year":"2020","journal-title":"In Vivo"},{"key":"10.1016\/j.radonc.2026.111647_b0380","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1186\/s13014-020-01653-w","article-title":"The role of carbon ion radiotherapy for unresectable locally recurrent rectal cancer: a single institutional experience","volume":"15","author":"Cai","year":"2020","journal-title":"Radiat Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0385","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1093\/jrr\/rrad068","article-title":"Definitive carbon ion re-irradiation with pencil beam scanning in the treatment of unresectable locally recurrent rectal cancer","volume":"64","author":"Cai","year":"2023","journal-title":"J Radiat Res"},{"key":"10.1016\/j.radonc.2026.111647_b0390","doi-asserted-by":"crossref","first-page":"1845","DOI":"10.1038\/s41598-022-05809-4","article-title":"Comparison of clinical outcomes between carbon ion radiotherapy and X-ray radiotherapy for reirradiation in locoregional recurrence of rectal cancer","volume":"12","author":"Chung","year":"2022","journal-title":"Sci Rep"},{"key":"10.1016\/j.radonc.2026.111647_b0395","doi-asserted-by":"crossref","first-page":"2068","DOI":"10.1245\/s10434-014-4219-z","article-title":"Reirradiation using carbon ions in patients with locally recurrent rectal cancer at HIT: first results","volume":"22","author":"Habermehl","year":"2015","journal-title":"Ann Surg Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0400","doi-asserted-by":"crossref","DOI":"10.3390\/cancers15113057","article-title":"Comparing oncologic outcomes and toxicity for combined modality therapy vs. carbon-ion radiotherapy for previously irradiated locally recurrent rectal cancer","volume":"15","author":"Jeans","year":"2023","journal-title":"Cancers (Basel)"},{"key":"10.1016\/j.radonc.2026.111647_b0405","doi-asserted-by":"crossref","first-page":"2473","DOI":"10.21873\/invivo.12983","article-title":"Safety and efficacy of re-irradiation with carbon-ion radiotherapy for pelvic recurrence of rectal cancer after preoperative chemoradiotherapy: a retrospective analysis","volume":"36","author":"Shiba","year":"2022","journal-title":"In Vivo"},{"key":"10.1016\/j.radonc.2026.111647_b0410","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1016\/j.radonc.2018.10.007","article-title":"Carbon-ion radiotherapy for locally recurrent rectal cancer: Japan Carbon-ion Radiation Oncology Study Group (J-CROS) study 1404 Rectum","volume":"132","author":"Shinoto","year":"2019","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0415","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1016\/j.ijrobp.2023.09.036","article-title":"Carbon-ion radiation therapy for unresectable locally recurrent colorectal cancer: a promising curative treatment for both radiation therapy: naive cases and reirradiation cases","volume":"118","author":"Takiyama","year":"2024","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.radonc.2026.111647_b0420","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.ijrobp.2016.04.022","article-title":"Carbon-ion radiation therapy for pelvic recurrence of rectal cancer","volume":"96","author":"Yamada","year":"2016","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.radonc.2026.111647_b0425","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1245\/s10434-021-10876-4","article-title":"Carbon ion radiotherapy for locally recurrent rectal cancer of patients with prior pelvic irradiation","volume":"29","author":"Yamada","year":"2022","journal-title":"Ann Surg Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0430","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1002\/jso.24757","article-title":"Carbon-ion radiotherapy for isolated para-aortic lymph node recurrence from colorectal cancer","volume":"116","author":"Isozaki","year":"2017","journal-title":"J Surg Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0435","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.1080\/0284186X.2020.1769184","article-title":"A systematic review of the role of carbon ion radiation therapy in recurrent rectal cancer","volume":"59","author":"Venkatesulu","year":"2020","journal-title":"Acta Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0440","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1016\/j.rpor.2020.04.019","article-title":"A critical literature review on the use of bellyboard devices to control small bowel dose for pelvic radiotherapy","volume":"25","author":"Hoffmann","year":"2020","journal-title":"Rep Pract Oncol Radiother"},{"key":"10.1016\/j.radonc.2026.111647_b0445","doi-asserted-by":"crossref","first-page":"491","DOI":"10.21037\/tcr.2019.11.33","article-title":"Effect of prone and supine treatment positions for postoperative treatment of rectal cancer on target dose coverage and small bowel sparing using intensity-modulated radiation therapy","volume":"9","author":"Yang","year":"2020","journal-title":"Transl Cancer Res"},{"key":"10.1016\/j.radonc.2026.111647_b0450","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1186\/s13014-017-0918-5","article-title":"The effect of prone and supine treatment positions for the pre-operative treatment of rectal cancer on organ-at-risk sparing and setup reproducibility using volumetric modulated arc therapy","volume":"12","author":"Kim","year":"2017","journal-title":"Radiat Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0455","doi-asserted-by":"crossref","unstructured":"Duffton A, Devlin L, Williamson A, Grose D, Tolmie E, MacLaren L, et al. Radiation therapist (RTT) perspectives on developing image-guided radiotherapy (IGRT) protocols for reirradiation. Technical Innovations & Patient Support in Radiation Oncology. 2025;35.","DOI":"10.1016\/j.tipsro.2025.100335"},{"key":"10.1016\/j.radonc.2026.111647_b0460","article-title":"IPEM Topical Report: an international IPEM survey of MRI use for external beam radiotherapy treatment planning","volume":"66","author":"Speight","year":"2021","journal-title":"Phys Med Biol"},{"key":"10.1016\/j.radonc.2026.111647_b0465","article-title":"Prospective radiotherapy quality Assurance leads to delineation guideline refinements for recurrent rectal cancer: experience from the PelvEx II study","volume":"52","author":"Piqeur","year":"2025","journal-title":"Clin Transl Radiat Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0470","doi-asserted-by":"crossref","DOI":"10.1016\/j.radonc.2024.110520","article-title":"Analysis of re-recurrent rectal cancer after curative treatment of locally recurrent rectal cancer","volume":"200","author":"Piqeur","year":"2024","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0475","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/j.radonc.2012.10.006","article-title":"Bioeffect modeling and equieffective dose concepts in radiation oncology\u2013terminology, quantities and units","volume":"105","author":"Bentzen","year":"2012","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0480","article-title":"Cumulative dose evaluation in clinical reirradiation - consensus guidance on technical considerations by the ESTRO reirradiation focus group","volume":"214","author":"Appelt","year":"2025","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0485","doi-asserted-by":"crossref","first-page":"e101","DOI":"10.1016\/S1470-2045(25)00562-5","article-title":"Reirradiation Collaborative Group (ReCOG) consensus on standards for dose evaluation and reporting in patients with multiple courses of radiation therapy: an AAPM\/ACRO\/ASTRO\/CARO\/COMP\/CADRA\/CPQR\/ESTRO\/NRG-endorsed consensus statement","volume":"27","author":"Paradis","year":"2026","journal-title":"Lancet Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0490","article-title":"Dose summation and image registration strategies for radiobiologically and anatomically corrected dose accumulation in pelvic re-irradiation","volume":"1\u20139","author":"Nix","year":"2021","journal-title":"Acta Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0495","doi-asserted-by":"crossref","DOI":"10.1016\/j.clon.2025.103861","article-title":"Dose accumulation for pelvic stereotactic ablative radiotherapy reirradiation","volume":"43","author":"Slevin","year":"2025","journal-title":"Clin Oncol (R Coll Radiol)"},{"key":"10.1016\/j.radonc.2026.111647_b0500","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1016\/j.ijrobp.2025.04.029","article-title":"Addressing clinical challenges of reirradiation: a continuum of evolving options","volume":"123","author":"Marks","year":"2025","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.radonc.2026.111647_b0505","doi-asserted-by":"crossref","DOI":"10.1016\/j.radonc.2023.109545","article-title":"Treatment plan optimisation for reirradiation","volume":"182","author":"Murray","year":"2023","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0510","doi-asserted-by":"crossref","DOI":"10.1016\/j.radonc.2025.110741","article-title":"Radiobiologically equivalent deformable dose mapping for re-irradiation planning: implementation, robustness, and dosimetric benefits","volume":"205","author":"Garcia-Alvarez","year":"2025","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0515","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.clon.2017.09.007","article-title":"UK consensus on normal tissue dose constraints for stereotactic radiotherapy","volume":"30","author":"Hanna","year":"2018","journal-title":"Clin Oncol (R Coll Radiol)"},{"key":"10.1016\/j.radonc.2026.111647_b0520","article-title":"Induction chemotherapy followed by chemoradiotherapy versus chemoradiotherapy alone as neoadjuvant treatment for locally recurrent rectal cancer: study protocol of a multicentre, open-label, parallel-arms, randomized controlled study (PelvEx II)","volume":"5","author":"PelvEx","year":"2021","journal-title":"BJS Open"},{"key":"10.1016\/j.radonc.2026.111647_b0525","doi-asserted-by":"crossref","first-page":"591","DOI":"10.7785\/tcrt.2012.500261","article-title":"Re-irradiation: outcome, cumulative dose and toxicity in patients retreated with stereotactic radiotherapy in the abdominal or pelvic region","volume":"11","author":"Abusaris","year":"2012","journal-title":"Technol Cancer Res Treat"},{"key":"10.1016\/j.radonc.2026.111647_b0530","article-title":"Isotoxic stereotactic reirradiation for recurrent pelvic cancers","volume":"37","author":"Pagett","year":"2026","journal-title":"Phys Imaging Radiat Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0535","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.radonc.2021.09.010","article-title":"An international Delphi consensus for pelvic stereotactic ablative radiotherapy re-irradiation","volume":"164","author":"Slevin","year":"2021","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0540","doi-asserted-by":"crossref","DOI":"10.3390\/cancers15194838","article-title":"Modern techniques in re-irradiation for locally recurrent rectal cancer: a systematic review","volume":"15","author":"Mantello","year":"2023","journal-title":"Cancers (Basel)"},{"key":"10.1016\/j.radonc.2026.111647_b0545","article-title":"Dose-escalated magnetic resonance image-guided abdominopelvic reirradiation with continuous intrafraction visualization, soft tissue tracking, and automatic beam gating","volume":"7","author":"Chuong","year":"2022","journal-title":"Adv Radiat Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0550","doi-asserted-by":"crossref","DOI":"10.1177\/1073274820969449","article-title":"Magnetic resonance guided radiotherapy for rectal cancer: expanding opportunities for non-operative management","volume":"27","author":"Tchelebi","year":"2020","journal-title":"Cancer Control"},{"key":"10.1016\/j.radonc.2026.111647_b0555","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.phro.2017.09.001","article-title":"The normal tissue sparing potential of an adaptive plan selection strategy for re-irradiation of recurrent rectal cancer","volume":"3","author":"Byskov","year":"2017","journal-title":"Phys Imaging Radiat Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0560","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1056\/NEJMoa060829","article-title":"Chemotherapy with preoperative radiotherapy in rectal cancer","volume":"355","author":"Bosset","year":"2006","journal-title":"N Engl J Med"},{"key":"10.1016\/j.radonc.2026.111647_b0565","doi-asserted-by":"crossref","first-page":"3687","DOI":"10.1200\/JCO.2007.15.3858","article-title":"Randomized phase III study comparing preoperative radiotherapy with chemoradiotherapy in nonresectable rectal cancer","volume":"26","author":"Braendengen","year":"2008","journal-title":"J Clin Oncol"},{"key":"10.1016\/j.radonc.2026.111647_b0570","doi-asserted-by":"crossref","first-page":"2610","DOI":"10.3748\/wjg.v12.i16.2610","article-title":"Three-dimensional conformal radiotherapy combined with FOLFOX4 chemotherapy for unresectable recurrent rectal cancer","volume":"12","author":"Hu","year":"2006","journal-title":"World J Gastroenterol"},{"key":"10.1016\/j.radonc.2026.111647_b0575","doi-asserted-by":"crossref","first-page":"1637","DOI":"10.1093\/bjs\/znad214","article-title":"Locally recurrent rectal cancer: oncological outcomes of neoadjuvant chemoradiotherapy with or without induction chemotherapy","volume":"110","author":"Nordkamp","year":"2023","journal-title":"Br J Surg"},{"key":"10.1016\/j.radonc.2026.111647_b0580","doi-asserted-by":"crossref","first-page":"2257","DOI":"10.1007\/s00384-022-04260-1","article-title":"Pathologic complete response after neoadjuvant chemotherapy\/(re)chemoradiation for pelvic relapse of rectal cancer undergoing complex pelvic surgery: more frequent than expected?","volume":"37","author":"Sorrentino","year":"2022","journal-title":"Int J Colorectal Dis"},{"key":"10.1016\/j.radonc.2026.111647_b0585","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1002\/bjs.10694","article-title":"Preliminary results of a cohort study of induction chemotherapy-based treatment for locally recurrent rectal cancer","volume":"105","author":"van Zoggel","year":"2018","journal-title":"Br J Surg"},{"key":"10.1016\/j.radonc.2026.111647_b0590","series-title":"Basic clinical radiobiology","author":"Joiner","year":"2019"}],"container-title":["Radiotherapy and Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S016781402600486X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S016781402600486X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T20:37:11Z","timestamp":1790714231000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S016781402600486X"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":118,"alternative-id":["S016781402600486X"],"URL":"https:\/\/doi.org\/10.1016\/j.radonc.2026.111647","relation":{},"ISSN":["0167-8140"],"issn-type":[{"value":"0167-8140","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"ESTRO recommendations for the use, planning and delivery of reirradiation in locally recurrent rectal cancer \u2013 Endorsed by ASTRO","name":"articletitle","label":"Article Title"},{"value":"Radiotherapy and Oncology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.radonc.2026.111647","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"simple-article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Authors. Published by Elsevier B.V.","name":"copyright","label":"Copyright"}],"article-number":"111647"}}