Would you consider salvage SRS in a young patient with locally recurrent ATRT?

Radiotherapy plays an important role in the curative management of ATRT.

[Chi et al, JCO 2009; Reddy et al JCO 2020].

When relapse occurs, even if it is local, the overall prognosis is often poor. However, I am assuming that this was previously treated, and I would consider re-irradiation with SRS as radiotherapy is effective in ATRT and can play an important role in the salvage.

In my experience, stereotactic radiosurgery (SRS) is a very well-tolerated, safe, and effective treatment of young children with distant recurrence of ATRT. These are generally very young children who require sedation. Nevertheless, as this is a single fraction, this is not problematic.

I have treated many cases with distant relapse and have generally used doses of 14...