{
  "abstract": "Background/Objectives: Thoracic re-irradiation is increasingly considered for recurrent, persistent, or new lung cancers after prior radiation therapy. The central clinical-technical challenge is relating prior and prospective doses across changes in anatomy, breathing state, fractionation, and imaging. Methods: This clinical-technical Perspective synthesizes consensus guidance, technical and the methodological literature, and representative clinical evidence to discuss rigid and deformable registration, dose mapping, biological normalization with EQD2/BED, uncertainty, quality assurance, and practical decision-making in lung re-irradiation. Results: Cumulative dose is an estimate with inherent uncertainty whose clinical value depends on the clinical question, anatomic stability, tissue correspondence, dose-transfer method, biological assumptions, and the consequence of error. Published cumulative dose constraints can provide useful orientation, but they are not universal pass/fail thresholds and should be interpreted together with their original endpoints, assumptions, and accumulation method. Conclusions: A focused, risk-adapted workflow can support more defensible use of cumulative dose in lung re-irradiation. Practical considerations in this article are intended to complement formal consensus guidance, institutional protocols, or patient-specific multidisciplinary judgment.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Radiation Oncology, Virginia Commonwealth University, 1001 East Leigh Street Rm 3-089, Richmond, VA 23219, USA.",
    "Department of Radiation Oncology, Medical College of Wisconsin, 8701 W Watertown Plank Rd., Milwaukee, WI 53226, USA.",
    "Department of Radiation Oncology, Cedars-Sinai Medical Center, 8700 Beverly Boulevard North Tower Lower Level, Los Angeles, CA 90048, USA."
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Mihaela Rosu-Bubulac",
      "orcid": "0000-0003-0732-4115"
    },
    {
      "affs": [
        1
      ],
      "name": "Hualiang Zhong",
      "orcid": "0000-0002-3519-0815"
    },
    {
      "affs": [
        2
      ],
      "name": "Indrin Julian Chetty"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9f20pcg8cn9hp.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15197527",
  "fulltext_url": "https://europepmc.org/articles/PMC13665798",
  "id": "9f20pcg8cn9hp",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://europepmc.org/article/MED/42881989",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "3108|Advanced Radiotherapy Techniques"
    ]
  ],
  "openalex": "W7214672581",
  "pdf_url": "https://europepmc.org/articles/PMC13665798?pdf=render",
  "pmcid": "PMC13665798",
  "pmid": "42881989",
  "published": "2026-09-28",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/9f20pcg8cn9hp.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:16Z",
      "native_id": "MED:42881989",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42881989"
    }
  ],
  "subjects": [
    {
      "field": "physics",
      "origin": "openalex:3108|Advanced Radiotherapy Techniques",
      "subfield": "applied-instrumentation"
    }
  ],
  "title": "Dose Mapping and Accumulation for Re-Irradiation of Lung Cancers: Methodological Principles, Uncertainties, Quality Assurance, and Practical Clinical Considerations.",
  "title_text": "Dose Mapping and Accumulation for Re-Irradiation of Lung Cancers: Methodological Principles, Uncertainties, Quality Assurance, and Practical Clinical Considerations.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:16Z",
  "url": "https://research.draconitic.com/paper/9f20pcg8cn9hp",
  "venue": "Journal of clinical medicine",
  "versions": []
}