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Clinical Oncologist and NHS Commissioner Perspectives on Reirradiation for Recurrent Cancer

Lookup NU author(s): Nick West

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

© 2026 The Authors. Published by Elsevier Ltd on behalf of The Royal College of Radiologists. This is an open access article under the CC BY license. http://creativecommons.org/licenses/by/4.0/ Aims: There is increasing interest in the potential benefits of reirradiation of recurrent or new primary cancer close to or within a previously irradiated region but there is a need for high-quality studies to evaluate this approach. This study aimed to understand clinician and NHS commissioner perspectives, methods for evidence generation, and the potential role of advanced technologies. Materials and methods: Semi-structured interviews were conducted with UK clinical oncologists and commissioners. Analysis was informed by principles of thematic analysis. Results: Interviews were conducted and analysed with 10 clinical oncologists and 2 commissioners. Six themes were developed: 1. Weighing potential benefits against uncertainties; 2. Considering patient preferences in clinical decision-making; 3. A desire for clear guidance on planning and delivering reirradiation; 4. Challenges in the availability of reirradiation; 5. A desire for a stronger evidence-base to guide clinical care; 6. Considerations for clinical trial design. Clinicians and commissioners were supportive of strengthening the evidence base and increasing availability of reirradiation. Some clinicians and both commissioners favoured doing so using clinical trials whereas others considered prospective registries or evaluative commissioning to be more feasible. The potential benefits that could be gained from advanced technologies were highlighted, but also that many patients could benefit from high-quality standard photon reirradiation. Conclusion: This study provides important insights into reirradiation practice and how to improve its availability. Perspectives regarding trials and advanced technologies should shape future study design to strengthen the evidence base.


Publication metadata

Author(s): Slevin F, Kendal S, Appelt AL, Aznar M, Benson R, Bhatnagar P, Chan C, Chowdhury S, Crellin A, Duffton A, Faivre-Finn C, Goody R, Harrison M, Harrow S, Henry AM, Hudson EM, Joseph E, Le Grange F, Nenclares P, Parker F, Smith A, Smith E, Spencer K, Sun F, Teo M, Thippu Jayaprakash K, Vasquez Osorio E, West N, Boele F, Murray LJ

Publication type: Article

Publication status: Published

Journal: Clinical Oncology

Year: 2026

Volume: 56

Print publication date: 01/08/2026

Online publication date: 28/05/2026

Acceptance date: 02/04/2018

Date deposited: 01/07/2026

ISSN (print): 0936-6555

ISSN (electronic): 1433-2981

Publisher: Elsevier Ltd

URL: https://doi.org/10.1016/j.clon.2026.104203

DOI: 10.1016/j.clon.2026.104203


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Funding

Funder referenceFunder name
National Institute for Health and Care Research (NIHR) under its Programme Development Grants (PDG) (Grant Reference Number NIHR206942)

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