I would layer the answer to the patient. First question: Local control, yes or no. If yes, then when... to answer that discussion of systemic option and timing in multiD eval. If yes, then how... surgery, IR thermal ablation, radiation. If radiation then dose/technique... 50 Gy 5 fx, 50 Gy 10 fx, 50...

This would depend entirely on the location of the recurrence and the overlapping dose from the prior plan with organs at risk, as well as the goals of care, patient performance status, and discussion of re irradiation risks. If directly in the mediastinum overlapping PBT/esophagus, there are signifi...