Would you offer liver re-irradiation in a Child-Pugh A patient with oligo-metastatic colon cancer to the liver, diagnosed > 10 years prior with previous TACE + SBRT to same liver metastasis ~5 years ago?

Would you offer re-irradiation for a patient a with liver malignancy s/p prior EBRT and Y-90 >3 years ago who is of good performance status and otherwise not a candidate for surgery, TACE, and has failed systemic therapy?

• I don't do it
• I may, depending on tumor size and location
• Radioembolization with Y-90 microspheres
• SBRT/IMRT with standard linac
• SBRT/IMRT with MRI-guided linac
• proton beam therapy
• Other