When do you consider re-irradiating patients with recurrent cervical cancer?

Because I have been seeing and treating a reasonable number of these cases for 35 years, I have some strong opinions on the matter. Although external beam re-irradiation in the setting of recurrent cervical cancer is fraught with great hazards and poor outcomes, interstitial re-irradiation has a hig...

We have done in few situations, HDR brachy alone EQ2 dose of 40 Gy using MRI guidance where there is delayed central only recurrence and patient is not a candidate or declines exenteration.
Bockel et al., PMID 33799617.

Another situation is SBRT for nodal recurrence in previously treated field - Ling...