Would you offer re-irradiation for recurrent vaginal bleeding?

Based on the previous dose, there is an opportunity for more doses for palliation.

Dose and fractionation would be driven by KPS and expected survival.

I have done quad shot, 30 in 12 to brachy in these situations based on the above.

Short answer, yes, OK to re-RT at 1 year post palliation for palliative intent. Depends on the severity of bleeding to start - requiring hospitalization, packing, and/or transfusions? Likely needs it more significantly.

Dosing, for me, depends on the overall clinical picture.

If diffusely metastatic...