尽管进行了初步放疗，但仍患有进展性恶性肿瘤的患者的治疗选择往往很有限。在某些情况下，可以提供重新照射。本文涉及某些类型癌症的选择标准和再照射结果。这篇综述基于 PubMed 选择性检索检索到的相关出版物，特别关注胶质母细胞瘤、头颈肿瘤和前列腺癌。关于再辐射的研究数量很少，而且方法质量往往有限。对于胶质母细胞瘤，一项随机对照试验 (RCT) 发现，在贝伐珠单抗治疗的基础上再进行放射治疗，对中位无进展生存期或中位总生存期没有显着改善（风险比 [HR] 0.73；p = 0.05 和 HR 0.98； p = 0.46，分别）。再次照射是初次放疗后头颈部肿瘤局部复发的一种治疗选择，但它存在严重副作用的风险。对于鼻咽癌不可切除的复发，随机对照试验表明超分割再照射比正常分割再照射更有效（总生存率：HR 0.54，p = 0.014）。对于放疗后局部复发的前列腺癌，再次放疗可以产生良好的肿瘤学结果，泌尿生殖和胃肠道副作用处于可接受的水平（5年无复发生存率：立体定向全身放疗（SBRT），58%；高剂量率（ HDR）近距离放射治疗，77%；与挽救性前列腺切除术，72%）。缺乏关于这一主题的随机对照试验。再照射是特定癌症患者的一种治疗选择。由于现有的科学证据有限，多学科合作和参与式决策尤为重要。

The treatment options for patients with progressive malignant tumors despite primary radiotherapy are often limited. In selected cases, re-irradiation can be offered. This article concerns the selection criteria and results of re-irradiation for certain types of cancer.This review is based on pertinent publications retrieved by a selective search in PubMed, with particular attention to glioblastoma, head and neck tumors, and prostatic carcinoma.The published studies of re-irradiation are few in number and often of limited methodological quality. For glioblastoma, a randomized controlled trial (RCT) found that adding re-irradiation to treatment with bevacizumab yielded no significant improvement in either median progression-free survival or median overall survival (hazard ratio [HR] 0.73; p = 0.05 and HR 0.98; p = 0.46, respectively). Re-irradiation is a treatment option for locoregional recurrences of head and neck tumors after primary radiotherapy, but it carries a risk of serious side effects. For unresectable recurrences of nasopharyngeal carcinoma, an RCT has shown that hyperfractionated re-irradiation is more effective than normofractionated re-irradiation (overall survival: HR 0.54, p = 0.014). For locally recurrent prostatic carcinoma after radiotherapy, re-irradiation can yield good oncologic outcomes with an acceptable level of urogenital and gastrointestinal side effects (5-year recurrence-free survival: stereotactic body radiation therapy (SBRT), 58%; high dose rate (HDR) brachytherapy, 77%; versus salvage prostatectomy, 72%). RCTs on this topic are lacking.Re-irradiation is a treatment option for selected cancer patients. As the available scientific evidence is limited, multidisciplinary collaboration and participatory decision-making are particularly important.