ESTRO recommendations for the use, planning and delivery of reirradiation in locally recurrent rectal cancer - Endorsed by ASTRO.

Reirradiation for locally recurrent rectal cancer (LRRC) has historically been restricted by concerns regarding significant adverse effects, particularly with reirradiation doses (in EQD2Gy) ≥ 30 Gy. Advances in radiation technology now enable safer delivery, renewing interest in (chemo)reirradiation as part of multimodal management. Given the scarcity of prospective data and the considerable variability in radiotherapy approaches, there is a clear need for recommendations to enhance treatment homogeneity and quality.