CA: A Cancer Journal for Clinicians最新文献

{"title":"Personalized care for patients with EGFR-mutant nonsmall cell lung cancer: Navigating early to advanced disease management.","authors":"Maxime Borgeaud,Timothée Olivier,Jair Bar,Stephanie Pei Li Saw,Kaushal Parikh,Giuseppe Luigi Banna,Claudio De Vito,Jill Feldman,Xiuning Le,Alfredo Addeo","doi":"10.3322/caac.70024","DOIUrl":"https://doi.org/10.3322/caac.70024","url":null,"abstract":"The discovery of activating mutations in the epidermal growth factor receptor (EGFR) gene has revolutionized the management of lung cancer, enabling the development of targeted tyrosine kinase inhibitors (TKIs). These therapies offer improved survival and reduced side effects compared with conventional treatments. Recent advancements have significantly reshaped the treatment paradigm for EGFR-mutant non-small cell lung cancer. TKIs are now incorporated into the management of early stage and locally advanced disease, and phase 3 trials have explored combination strategies in metastatic settings. Although these intensified approaches improve progression-free survival, they come with increased toxicity and higher costs, underscoring the need for precise patient selection to maximize benefit. Emerging data on biomarkers, such as co-mutations and circulating tumor DNA, show promise for refining treatment decisions. In addition, significant progress in understanding resistance mechanisms to EGFR TKIs has broadened therapeutic options. This review provides a comprehensive overview of the current landscape of EGFR-mutant nonsmall cell lung cancer, highlighting recent breakthroughs and discussing strategies to optimize treatment based on the latest evidence.","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"13 1","pages":""},"PeriodicalIF":254.7,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is active surveillance an alternative to surgery for some patients with esophageal cancer?","authors":"Carrie Printz","doi":"10.3322/caac.70023","DOIUrl":"https://doi.org/10.3322/caac.70023","url":null,"abstract":"<p>Overall survival with active surveillance was noninferior to overall survival with surgery after 2 years for some patients with esophageal cancer who achieved a clinical complete response after neoadjuvant chemoradiotherapy, according to researchers.</p><p>Results from the phase 3, randomized study showed that the overall survival rate was 74% for patients undergoing active surveillance and 71% for patients having surgery.</p><p>The authors caution that their research will require extended follow-up to determine the long-term efficacy of active surveillance. Some esophageal surgeons have concerns about the trial’s design and findings.</p><p>Results of the Neoadjuvant Chemoradiotherapy Followed by Active Surveillance Versus Standard Surgery for Esophageal Cancer (SANO) trial appear in <i>The Lancet</i> (doi:10.1016/S1470-2045(25)00027-0).</p><p>Kimberly Wilson, a survivor of stage IV esophageal cancer and patient advocate who underwent surgery in 2022, supports the study’s efforts to assess all potential treatment options for the disease.</p><p>“I believe very strongly in research supporting a wide variety of patients’ needs and perspectives to draw in the medical community’s ability to provide patients with multiple options,” says Wilson, a program specialist for the Esophageal Cancer Action Network, who had a total esophagectomy in 2022 after undergoing chemotherapy, radiation, and immunotherapy.</p><p>Unable to avoid surgery because of her advanced disease, Wilson says that she fits into the rare category of stage IV esophageal cancer “thrivers” who continue to live fairly regular lives—albeit at a slower pace.</p><p>“My stomach was pulled up to make what now functions as my esophagus,” she says. “Despite how challenging the surgery was, I would do it again.”</p><p>The phase 3, randomized SANO trial is a multicenter study of patients in 12 Dutch hospitals. The research was conducted between November 2017 and January 2021. Participants had locally advanced esophageal cancer and a clinical complete response after chemoradiotherapy. After screening 1115 patients, researchers included 309 individuals: 198 participants went on active surveillance, whereas 111 had the standard surgery. The standard surgery was esophagectomy within the 2 weeks after a clinical complete response was achieved.</p><p>Seventy-eight percent of the participants were male, and 22% were female. The primary end point was overall survival, which was analyzed according to a modified intention-to-treat principle allowing crossover at the time of clinical complete response and an intention-to-treat principle. The median follow-up was 38 months. Secondary end points included progression-free survival, health-related quality of life, and treatment-related morbidity and mortality.</p><p>The 2-year overall survival rate with active surveillance (74%) was noninferior to the rate with standard surgery (71%) after the modified intention-to-treat analysis. In the intention-to-treat ana","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"75 4","pages":"274-276"},"PeriodicalIF":503.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144537066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chemotherapy-induced taste changes affect nutrition, quality of life","authors":"Carrie Printz","doi":"10.3322/caac.70022","DOIUrl":"https://doi.org/10.3322/caac.70022","url":null,"abstract":"<p>Although chemotherapy helps to prevent cancer growth in many patients, it also can destroy healthy cells that may cause taste changes and appetite loss. Many patients experience taste alteration as a common symptom but do not report it, and health care professionals may overlook the condition because it is not life-threatening.</p><p>A Turkish study reported that 67.7% of participants treated with chemotherapy experienced a change in taste. Researchers also found that 21.8% of patients were at moderate risk for malnutrition. Quality of life was also diminished in correlation with the intensity of taste changes.</p><p>Researchers found that patients with oral mucositis, dry mouth, gingival sensitivity, and gingival pain had a significantly higher severity of taste alteration and poorer quality of life. The study appears in <i>Supportive Care in Cancer</i> (doi:10.1007/s00520-025-09431-8).</p><p>The descriptive and cross-sectional study analyzed 330 patients, aged 18 years or older, who were receiving at least two outpatient chemotherapy treatments for cancer at a Turkish university hospital between March and June 2023. Participants were interviewed in person with the Descriptive Characteristics Form, the Chemotherapy-Induced Taste Alteration Scale, the Malnutrition Universal Screening Tool, and the World Health Organization Quality of Life Questionnaire.</p><p>More than half (57.6%) of the participants were 60 years old or older and female (51.8%). Thirty-seven percent of the participants were obese, 47.6% were smokers, and 27.6% had breast cancer; 39.7% were undergoing chemotherapy for five cycles or fewer, 40% were undergoing chemotherapy every 2 weeks, and 52% were not receiving any additional therapy.</p><p>Findings showed that 67.7% of the patients reported taste alterations of moderate severity, 77.9% had mouth sores, 88.5% had dry mouth, 83.9% had gingival sensitivity, and 17.9% had gingival pain. In the group, 21.8% were at moderate risk for malnutrition. More than half the patients (54.8%) lost weight after chemotherapy, and this correlated with significantly greater taste changes. Researchers identified a statistically significant correlation among taste alteration, malnutrition, and quality-of-life scores, with taste alteration being highly predictive of both conditions.</p><p>Taste alteration was higher in women than men and higher in patients with breast cancer than those with gastrointestinal, lung, urinary, or hematologic cancers. Taste alteration was lower in patients with a good or very good appetite in comparison with those with a poor or moderate appetite.</p><p>No statistically significant differences were found in taste alteration with age or the number of chemotherapy treatments between patients with a good or very good appetite and patients with a poor or moderate appetite.</p><p>Findings showed a statistically significant association between taste alteration and oral mucositis, dry mouth, gingival sensitivity and pain, r","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"75 4","pages":"271-273"},"PeriodicalIF":503.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144536891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The contemporary management of prostate cancer.","authors":"Deep Chakrabarti, Peter Albertsen, Aidan Adkins, Amar Kishan, Vedang Murthy, Chris Parker, Angela Pathmanathan, Alison Reid, Oliver Sartor, Nicholas Van As, Jochen Walz, Alison Tree","doi":"10.3322/caac.70020","DOIUrl":"https://doi.org/10.3322/caac.70020","url":null,"abstract":"<p><p>Prostate cancer is the most common cancer in two thirds of the world, with an expected doubling in both incidence and mortality in the next two decades. No strong environmental associations exist for the development of prostate cancer; therefore, lifestyle measures are unlikely to mitigate this increasing burden. The last three decades have seen rapid developments in the diagnostic and therapeutic landscape of prostate cancer, including multiparametric magnetic resonance imaging, positron emission tomography, robotic surgery, image-guided hypofractionated and stereotactic radiotherapy, novel anti-androgens and radioligand therapies. Prostate cancer is unique in that not everyone with a diagnosis needs treatment, and active surveillance is the preferred option for some. This review discusses the contemporary management of all stages of prostate cancer in the light of these modern developments, enabling holistic individualization of treatment, and describes the promise of future research to further improve outcomes.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":" ","pages":""},"PeriodicalIF":503.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The contemporary management of prostate cancer.","authors":"Deep Chakrabarti,Peter Albertsen,Aidan Adkins,Amar Kishan,Vedang Murthy,Chris Parker,Angela Pathmanathan,Alison Reid,Oliver Sartor,Nicholas Van As,Jochen Walz,Alison Tree","doi":"10.3322/caac.70020","DOIUrl":"https://doi.org/10.3322/caac.70020","url":null,"abstract":"Prostate cancer is the most common cancer in two thirds of the world, with an expected doubling in both incidence and mortality in the next two decades. No strong environmental associations exist for the development of prostate cancer; therefore, lifestyle measures are unlikely to mitigate this increasing burden. The last three decades have seen rapid developments in the diagnostic and therapeutic landscape of prostate cancer, including multiparametric magnetic resonance imaging, positron emission tomography, robotic surgery, image-guided hypofractionated and stereotactic radiotherapy, novel anti-androgens and radioligand therapies. Prostate cancer is unique in that not everyone with a diagnosis needs treatment, and active surveillance is the preferred option for some. This review discusses the contemporary management of all stages of prostate cancer in the light of these modern developments, enabling holistic individualization of treatment, and describes the promise of future research to further improve outcomes.","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"27 1","pages":""},"PeriodicalIF":254.7,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urothelial carcinoma: Perioperative considerations from top to bottom","authors":"Wesley Yip, Salvador Jaime-Casas, Anjaney Kothari, Mary Sullivan, Leslie K. Ballas, Domenique Escobar, Anne K. Schuckman, Jonathan E. Rosenberg, Jonathan A. Coleman","doi":"10.3322/caac.70019","DOIUrl":"https://doi.org/10.3322/caac.70019","url":null,"abstract":"Urothelial carcinoma is an aggressive entity that is associated with significant morbidity, but there have been major advances in both our understanding of and treatment options for patients with this disease. In this review, the authors focus on novel therapeutic and diagnostic approaches in the perioperative setting, with an emphasis on patient-centered and individualized care. For urothelial carcinoma of the bladder (UCB), advances in nonplatinum-based therapies, specifically immunotherapy and antibody–drug conjugates, have expanded the therapeutic arsenal for patients with muscle-invasive UCB in both the neoadjuvant and adjuvant settings to improve survival outcomes. Given the significant morbidity of extirpative surgery (radical cystectomy and urinary diversion), there have also been greater efforts to evaluate bladder-sparing protocols and improve the selection of patients for surgery and their postoperative recovery. The authors review special considerations for organ-sparing surgery in females, geriatric co-management, and enhanced recovery after surgery protocols. For upper tract urothelial carcinoma, there has been increasing recognition of its unique diagnostic and therapeutic challenges, including risks of renal functional loss. There have been advances in molecular profiling that have demonstrated various genomic differences between upper tract urothelial carcinoma and UCB, with treatment implications. This article reviews studies evaluating perioperative care that focused on optimizing therapeutic approaches, including neoadjuvant/adjuvant chemotherapy and immunotherapy, as well as nephron-sparing strategies in carefully selected cases.","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"10 1","pages":""},"PeriodicalIF":254.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144237423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast cancer in a transgender man","authors":"Alison May Berner, Tristan Michael MacKenzie, Shirish Kulkarni, Chin Chong, Loren Schechter, Caroline Michie, Ole-Petter Riksfjord Hamnvik","doi":"10.3322/caac.70021","DOIUrl":"https://doi.org/10.3322/caac.70021","url":null,"abstract":"<h2> CASE PRESENTATION</h2>\u0000<p>A 52-year-old transgender man presented for evaluation of a new diagnosis of breast cancer. The patient was designated female at birth. Three months after initiation of gender-affirming hormone therapy (GAHT) with testosterone gel, he underwent bilateral mastectomy for gender affirmation. Final pathology revealed a left-sided, pathologic T1 tumor (pT1) that was identified as grade 2 invasive ductal carcinoma and as estrogen receptor (ER)-positive, progesterone receptor-negative, and human epidermal growth factor receptor 2 (HER2)-negative by immunohistochemistry (score, 1+). The patient reported no preoperative symptoms of breast lumps or any changes to the skin of the breast or the nipples. He had a past medical history of Barrett esophagus, depression, and orthopedic surgeries. He had no history of chest irradiation. Family history was negative for breast or ovarian cancer. Of note, he had a negative screening mammogram performed 5 years earlier; repeat screening had not been obtained.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"447 1","pages":""},"PeriodicalIF":254.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer treatment and survivorship statistics, 2025","authors":"Nikita Sandeep Wagle PhD, MBBS, MHA,&nbsp;Leticia Nogueira PhD, MPH,&nbsp;Theresa P. Devasia PhD,&nbsp;Angela B. Mariotto PhD,&nbsp;K. Robin Yabroff PhD,&nbsp;Farhad Islami MD, PhD,&nbsp;Ahmedin Jemal DVM, PhD,&nbsp;Rick Alteri MD,&nbsp;Patricia A. Ganz MD,&nbsp;Rebecca L. Siegel MPH","doi":"10.3322/caac.70011","DOIUrl":"10.3322/caac.70011","url":null,"abstract":"<p>The number of people living with a history of cancer in the United States continues to rise because of the growth and aging of the population as well as improved survival through advances in early detection and treatment. To assist the public health community serve the needs of these survivors, the American Cancer Society and the National Cancer Institute collaborate triennially to estimate cancer prevalence in the United States using data from the Surveillance, Epidemiology, and End Results cancer registries, the Centers for Disease Control and Prevention's National Center for Health Statistics, and the United States Census Bureau. In addition, cancer treatment patterns are presented from the National Cancer Database along with a brief overview of treatment-related side effects. As of January 1, 2025, about 18.6 million people were living in the United States with a history of cancer, and this number is projected to exceed 22 million by 2035. The three most prevalent cancers are prostate (3,552,460), melanoma of the skin (816,580), and colorectum (729,550) among males and breast (4,305,570), uterine corpus (945,540), and thyroid (859,890) among females. About one half (51%) of survivors were diagnosed within the past 10 years, and nearly four fifths (79%) were aged 60 years and older. Racial differences in treatment in 2021 were common across disease stage; for example, Black people with stage I-II lung cancer were less likely to undergo surgery than their White counterparts (47% vs. 52%). Larger disparities exist for rectal cancer, for which 39% of Black people with stage I disease undergo proctectomy or proctocolectomy compared to 64% of their White counterparts. Targeted, multi-level efforts to expand access to high-quality care and survivorship resources are vital to reducing disparities and advancing support for all survivors of cancer.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"75 4","pages":"308-340"},"PeriodicalIF":503.1,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer treatment and survivorship statistics, 2025: An urgent call to optimize health after cancer","authors":"Lidia Schapira MD,&nbsp;Christine M. Duffy MD","doi":"10.3322/caac.70017","DOIUrl":"10.3322/caac.70017","url":null,"abstract":"&lt;p&gt;The publication of the American Cancer Society’s “Cancer Treatment and Survivorship Statistics, 2025” report affirms that the number of people living in the United States with a history of cancer is rising because of advances in detection and treatment that have improved survival.&lt;span&gt;&lt;sup&gt;1, 2&lt;/sup&gt;&lt;/span&gt; In our opinion, it also presents a new opportunity to engage all stakeholders in the discourse on cancer survivorship. More cancers have become treatable and controllable, and the sheer number of survivors demands a concerted approach involving a trained health care workforce, accessible referral pathways, and adequate reimbursement for services rendered.&lt;/p&gt;&lt;p&gt;There are reasons to celebrate the findings as we learn that general cancer mortality continues to fall, with an overall incidence decline in men. Yet these improvements are not distributed equally among subpopulations because cancer mortality continues to rise in women, and we are presented with evidence of the persistence of disparities in access to life-saving cancer treatment and receipt of guideline-concordant care. For instance, there is evidence that patients with private insurance are twice as likely to receive recommended treatment for stage II–III colon cancer compared with patients who are uninsured, and Black patients are less likely than White patients to receive surgery for early stage colon and rectal cancers.&lt;span&gt;&lt;sup&gt;3, 4&lt;/sup&gt;&lt;/span&gt; Disparities in receipt of guideline-concordant care have been reported for patients with many solid tumors,&lt;span&gt;&lt;sup&gt;5, 6&lt;/sup&gt;&lt;/span&gt; and this inevitably leads to worse outcomes.&lt;/p&gt;&lt;p&gt;The global disruption caused by the coronavirus disease 2019 pandemic will continue to be studied for years, but some of its consequential effects are beginning to surface. Among them are delays in screening and disruptions in care pathways that contribute to stage migration.&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/span&gt; In addition, the pandemic exposed fault lines across health care systems and exacerbations in disparities in cancer care. Other global events, including wars and famine that lead to massive migration, will undoubtedly have an impact on global cancer statistics in years to come.&lt;/p&gt;&lt;p&gt;Robust data banks are essential to advancing our understanding of long-term outcomes in cancer survivors. Studies like the St Jude Lifetime Cohort and the Childhood Cancer Survivor Study have generated invaluable insights into survivorship in pediatric populations. The National Cancer Institute-funded cancer epidemiology survivor cohorts, which were established to follow survivors over time to capture data on treatment exposures, long-term health outcomes, and social determinants of health, are an important step that will inform future interventions and guidelines for care, but comprehensive population-based surveillance of survivorship outcomes remains limited.&lt;span&gt;&lt;sup&gt;8&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Growing recognition of the toxicities and long-term burdens associated with cancer t","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"75 4","pages":"277-279"},"PeriodicalIF":503.1,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reirradiation: Standards, challenges, and patient-focused strategies across tumor types","authors":"Arnaud Beddok, Jonas Willmann, Anna Embring, Ane L. Appelt, Panagiotis Balermpas, Kevin Chua, J. Isabelle Choi, Bernice Simone Elger, Dorota Gabrys, Peter Hoskin, Maximilian Niyazi, David Pasquier, Kelly Paradis, Orit Kaidar-Person, Corien Plaisier, Nicole C. Schmitt, Conor E. Steuer, Juliette Thariat, Sue S. Yom, Philip Poortmans, Eliana Vasquez Osorio, Nicolaus Andratschke","doi":"10.3322/caac.70016","DOIUrl":"https://doi.org/10.3322/caac.70016","url":null,"abstract":"Reirradiation (reRT), defined as administering a course of radiation therapy to a specific area previously irradiated, is an evolving treatment strategy for locoregionally recurrent cancer that offers significant potential and poses inherent challenges. Advances in such techniques as intensity-modulated and stereotactic body radiation therapy have improved precision, making reRT a viable option for complex scenarios previously deemed high-risk. Nevertheless, reRT remains associated with substantial risks—including life-threatening side effects, functional impairments, and psychosocial effects—which must be carefully balanced against the patient's overall health and the likelihood of achieving cancer control or palliation. Patient selection is essential to optimize outcomes while mitigating risks. Decisions should account for tumor characteristics at the time of primary diagnosis and recurrence, elapsed time since prior treatment, the possibility of delivering meaningful doses to the tumor, and the cumulative irradiation tolerance of normal tissues. Advanced imaging modalities, such as functional magnetic resonance imaging and fluorine-18–labeled fluorodeoxyglucose–positron emission tomography, are important for distinguishing recurrences from treatment-induced changes, refining treatment targets, and minimizing exposure to healthy tissue. Combined treatment with systemic regimens—targeted therapies and immunotherapy in particular—offers promising opportunities but requires coordination to manage side effects. Standardized guidelines, such as those from the European Society of Therapeutic Radiology and Oncology-European Society for Research and Treatment of Cancer, are essential for improving the consistency of reporting, guiding clinical decision making, and fostering patient-centered care. Multidisciplinary collaboration and ongoing research, particularly through clinical trials, are central to fully exploiting reRT strategies. In addition, the development of innovative techniques, such as proton therapy, would likely enable safer treatments. These efforts aim to improve the therapeutic balance of reRT, enhancing outcomes and quality of life.","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"87 1","pages":""},"PeriodicalIF":254.7,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144165671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}