ESTRO-ASTRO Consensus Recommendations for Reirradiation in Locally Recurrent Rectal Cancer

ESTRO-ASTRO consensus: (chemo)reirradiation for locally recurrent rectal cancer can increase radical resection rate and improve control, but recommendations rely on low-quality evidence and expert consensus. Careful patient selection and precision techniques essential.

• A systematic review of 14 key questions informed the consensus; recommendations were graded using the ASTRO system.
• Evidence was predominantly low-quality (expert consensus); urgent need for prospective registry data and trials.
• Multimodal reirradiation may be used neoadjuvantly, definitively, or palliatively to enhance local and symptom control.

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