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Contributors; Normal Tissue Tolerance toßReirradiation; 1 Introduction; 2 Acute Reactions; 2.1 Skin andßMucosa; 2.2 Intestine; 3 Late Side Effects; 3.1 Epithelial andßMesenchymal Tissues; 3.2 Thoracic Aorta andßCarotid Arteries; 3.3 Intestine; 3.4 Lung; 3.5 Spinal Cord; 3.6 Brain; 3.7 Heart; 3.8 Bladder; 3.9 Kidney; 4 Liver; 5 Discussion; References; Fractionation Concepts; 1 Background; 2 Hyperfractionation inßFirst-ƯLine Radiotherapy; 3 Hyperfractionated Reirradiation; 4 Low-Dose Ultrafractionation; 5 Pulse-Reduced Dose Rate (PRDR) Reirradiation.
6 Hypofractionation inßRandomized Clinical Reirradiation Studies7 A Small Randomized Study ofßConventionally Fractionated External Beam Radiotherapy VersusßHigh-ƯDose-ƯRate (HDR) Brachytherapy; References; Hyperthermia andßReirradiation; 1 Hyperthermia inßClinical Oncology; 1.1 Classical Hyperthermia Treatment Techniques; 1.1.1 Superficial Hyperthermia; 1.1.2 Interstitial andßEndocavitary/Intraluminal Hyperthermia; 1.1.3 Deep Regional Hyperthermia; 1.1.4 Noninvasive Thermometry; 1.1.5 Whole-Body Hyperthermia; 1.2 Hyperthermia: Not anßAlternative butßAdditive Treatment Option.
2 The Rationale toßIntegrate Hyperthermia intoßMultimodality Approaches forßtheßTreatment ofßRecurrent Malignancies3 Clinical Data; 3.1 Breast Cancer; 3.2 Rectal Cancer; 3.3 Head andßNeck Cancer; 3.4 Cervical Cancer; 4 Summary; References; Therapeutic Ratio ofßReirradiation withßCytotoxic Drugs andßOther Response-Modifying Agents; 1 Introduction; 2 Clinical Relevance ofßCombined Modality Approaches; 3 Basic Considerations; 3.1 Therapeutic Gain; 3.2 Additivity, Synergism, andßSubadditivity; 3.2.1 Synergism (Supraadditivity); 3.2.2 Additivity.
3.2.3 Infra (Sub)-additivity (Protection)4 Interaction ofßRadiation andßChemotherapy; 4.1 Spatial Interaction; 4.2 Role ofßRepopulation; 4.3 Role ofßHypoxia; 5 Molecular Interactions; 5.1 DNA Damage; 5.2 Radiation Sensitization viaßCell Cycle Synchronization; 6 Radiation andßPlatinum-ƯBased Drugs: Example ofßClinically Established Combined Modality Treatments; 6.1 Cisplatin; 6.2 Carboplatin; 6.3 Oxaliplatin; 7 Combined Modality Reirradiation; References; Reduced Normal Tissue Doses Through Advanced Technology.
1 Introduction: Errors, Margins andßCompensation Strategies inßRadiotherapy1.1 Rationale forßAdvanced Technologies inßtheßReirradiation Situation; 1.2 Uncertainties inßRadiotherapy andßCompensation Strategies; 1.3 Safety Margins inßRadiotherapy; 2 Imaging forßReirradiation; 3 Photon External Beam Radiotherapy; 3.1 Conventional Two- Dimensional Radiotherapy; 3.2 Three-Dimensional Conformal Radiotherapy; 3.3 Intensity-Modulated Radiotherapy; 4 Three andßFour Dimensional Treatment Plan Evaluation; 5 Stereotactic Radiotherapy andßImage Guidance; 6 Intrafractional Motion Management.
6 Hypofractionation inßRandomized Clinical Reirradiation Studies7 A Small Randomized Study ofßConventionally Fractionated External Beam Radiotherapy VersusßHigh-ƯDose-ƯRate (HDR) Brachytherapy; References; Hyperthermia andßReirradiation; 1 Hyperthermia inßClinical Oncology; 1.1 Classical Hyperthermia Treatment Techniques; 1.1.1 Superficial Hyperthermia; 1.1.2 Interstitial andßEndocavitary/Intraluminal Hyperthermia; 1.1.3 Deep Regional Hyperthermia; 1.1.4 Noninvasive Thermometry; 1.1.5 Whole-Body Hyperthermia; 1.2 Hyperthermia: Not anßAlternative butßAdditive Treatment Option.
2 The Rationale toßIntegrate Hyperthermia intoßMultimodality Approaches forßtheßTreatment ofßRecurrent Malignancies3 Clinical Data; 3.1 Breast Cancer; 3.2 Rectal Cancer; 3.3 Head andßNeck Cancer; 3.4 Cervical Cancer; 4 Summary; References; Therapeutic Ratio ofßReirradiation withßCytotoxic Drugs andßOther Response-Modifying Agents; 1 Introduction; 2 Clinical Relevance ofßCombined Modality Approaches; 3 Basic Considerations; 3.1 Therapeutic Gain; 3.2 Additivity, Synergism, andßSubadditivity; 3.2.1 Synergism (Supraadditivity); 3.2.2 Additivity.
3.2.3 Infra (Sub)-additivity (Protection)4 Interaction ofßRadiation andßChemotherapy; 4.1 Spatial Interaction; 4.2 Role ofßRepopulation; 4.3 Role ofßHypoxia; 5 Molecular Interactions; 5.1 DNA Damage; 5.2 Radiation Sensitization viaßCell Cycle Synchronization; 6 Radiation andßPlatinum-ƯBased Drugs: Example ofßClinically Established Combined Modality Treatments; 6.1 Cisplatin; 6.2 Carboplatin; 6.3 Oxaliplatin; 7 Combined Modality Reirradiation; References; Reduced Normal Tissue Doses Through Advanced Technology.
1 Introduction: Errors, Margins andßCompensation Strategies inßRadiotherapy1.1 Rationale forßAdvanced Technologies inßtheßReirradiation Situation; 1.2 Uncertainties inßRadiotherapy andßCompensation Strategies; 1.3 Safety Margins inßRadiotherapy; 2 Imaging forßReirradiation; 3 Photon External Beam Radiotherapy; 3.1 Conventional Two- Dimensional Radiotherapy; 3.2 Three-Dimensional Conformal Radiotherapy; 3.3 Intensity-Modulated Radiotherapy; 4 Three andßFour Dimensional Treatment Plan Evaluation; 5 Stereotactic Radiotherapy andßImage Guidance; 6 Intrafractional Motion Management.