Would you offer re-irradiation for an upper GI bleed secondary to a necrotic, intraluminal gastric Merkel cell metastasis previously treated with 50 Gy in 25 fractions roughly one year ago?

Although we prefer to avoid re-irradiation, it needs to be compared to the other options for stopping bleeding from a necrotic tumor. If there is an appropriate artery to embolize, for example, that may be an appropriate approach. In many cases, though, there will not be good alternatives to radiati...