†These authors contributed equally.
Background: Re-irradiation of patients with previously irradiated
gynecological tumors represents one of the hot topics of modern oncology. It is
generally performed using Brachytherapy (alone or after external beam radiation
therapy (EBRT) re-treatment) or Stereotactic Body Radiotherapy (SBRT). Literature
provides few data concerning SBRT re-irradiation (re-RT). Here we provided a statistical
and comparative analysis of the studies to make a general assessment of the
efficacy and reliability of SBRT, considering the potential benefits achievable
in terms of local control, overall survival and toxicity. Methods: A
computerized literature search was performed in 3 electronic databases (MEDLINE,
EMBASE, and Cochrane) from 1996 to 2020. Only studies analysing outcomes of
re-irradiated (re-I) patients were taken into consideration. Quality assessment
score and risk of bias were assessed for each article. Random-effects models were
used due to great subjectivity given the lack of related control groups in the
non-comparative studies and a tendency towards high heterogeneity (examined by
the Cochran Q chi-square test and the I