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Peer-reviewedCC BY-NC-NDReports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology

Clinical approaches to re-irradiation in the MENA region: insights from 115 radiation oncologists.

  • Rim Alami1,2
  • Reyzane El Mjabber1,2
  • Raouia Ben Amor3,4
  • Houda Doghmani1
  • Maha Doghmani1
  • Mohamed Ismail5
  • Saad Maili Al-Rashidi6
  • Abdelkader Acharki7
  • Abdelhak Maghous8,9
  • Fadila Kouhen10,11,12
12 affiliations
  1. 1Mohammed VI Faculty of Medicine, Mohammed VI University of Sciences and Health (UM6SS), Casablanca, Morocco.
  2. 2Department of Radiotherapy, International University Hospital Cheikh Khalifa, Casablanca, Morocco.
  3. 3Faculty of Medicine of Tunis, University of Tunis El Manar, Ariana, Tunisia.
  4. 4Department of Radiation Oncology, Abderrahmen Mami Hospital, Ariana, Tunisia.
  5. 5Department of Clinical Oncology, New Kasr El Aini University Hospital, Cairo, Egypt.
  6. 6Department of Radiation Oncology, King Fahad Medical City, Riyadh, Saudi Arabia.
  7. 7Ryad Oncologia Clinic, Casablanca, Morocco.
  8. 8Faculty of Medicine and Pharmacy Casablanca (FMPC), Hassan II University, Morocco.
  9. 9Mohammed V Military Teaching Hospital, Rabat, Morocco.
  10. 10Mohammed VI Faculty of Medicine, Mohammed VI University of Sciences and Health (UM6SS), Rabat, Morocco.
  11. 11Laboratory of Neurooncology, Oncogenetic and Personalized Medicine, Faculty of Medicine, Mohammed VI University of Sciences and Health (UM6SS), Casablanca, Morocco.
  12. 12Department of Radiotherapy, Mohammed VI International University Hospital, Rabat, Morocco.
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Abstract

Re-irradiation is increasingly used in the management of recurrent cancers, yet it remains a technically demanding procedure, particularly in regions with heterogeneous access to radiotherapy resources. The Middle East and North Africa (MENA) region comprises countries with diverse infrastructure, but no multicountry evaluation of re-irradiation practices has previously been conducted. A 37-item online survey was administered to radiation oncology residents, specialists, and professors from six MENA countries between June 2024 and March 2025. The questionnaire explored clinical exposure to re-irradiation, indications, treatment techniques, dose assessment methods, decision-making criteria, and perceived training needs. Data were analysed using descriptive statistics. A total of 115 clinicians responded. The most frequent indications for re-irradiation were local recurrence (90%) and metastatic disease (67%). Advanced techniques such as IMRT and SBRT were commonly used (87%). Preferred inter-treatment intervals were 6-12 months (35%) and 12-24 months (38%). Cumulative dose and treated volume were identified as key decision-making parameters by most participants (94%). Major challenges included cumulative dose estimation (90%), concerns regarding toxicity (80%), the lack of standardised guidelines (56%), and limited access to advanced planning tools, including deformable image registration. EQD2 was systematically used for biological dose summation by all respondents. This first multicountry assessment from the MENA region reveals considerable variability in re-irradiation practices and underscores gaps in infrastructure, standardisation, and training. These results highlight the need for region-specific guidelines and collaborative efforts to optimise safe and consistent re-irradiation approaches.

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Cite

BibTeXRIS
BibTeX
@article{alami2026clinical,
  title = {{Clinical approaches to re-irradiation in the MENA region: insights from 115 radiation oncologists.}},
  author = {Rim Alami and Reyzane El Mjabber and Raouia Ben Amor and Houda Doghmani and Maha Doghmani and Mohamed Ismail and Saad Maili Al-Rashidi and Abdelkader Acharki and Abdelhak Maghous and Fadila Kouhen},
  journal = {Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology},
  year = {2026},
  month = nov,
  doi = {10.5603/rpor.113085},
  url = {https://europepmc.org/article/MED/42997873},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Clinical approaches to re-irradiation in the MENA region: insights from 115 radiation oncologists.
AU  - Rim Alami
AU  - Reyzane El Mjabber
AU  - Raouia Ben Amor
AU  - Houda Doghmani
AU  - Maha Doghmani
AU  - Mohamed Ismail
AU  - Saad Maili Al-Rashidi
AU  - Abdelkader Acharki
AU  - Abdelhak Maghous
AU  - Fadila Kouhen
PY  - 2026
DA  - 2026/11/01
JO  - Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology
DO  - 10.5603/rpor.113085
UR  - https://europepmc.org/article/MED/42997873
AB  - Re-irradiation is increasingly used in the management of recurrent cancers, yet it remains a technically demanding procedure, particularly in regions with heterogeneous access to radiotherapy resources. The Middle East and North Africa (MENA) region comprises countries with diverse infrastructure, but no multicountry evaluation of re-irradiation practices has previously been conducted. A 37-item online survey was administered to radiation oncology residents, specialists, and professors from six MENA countries between June 2024 and March 2025. The questionnaire explored clinical exposure to re-irradiation, indications, treatment techniques, dose assessment methods, decision-making criteria, and perceived training needs. Data were analysed using descriptive statistics. A total of 115 clinicians responded. The most frequent indications for re-irradiation were local recurrence (90%) and metastatic disease (67%). Advanced techniques such as IMRT and SBRT were commonly used (87%). Preferred inter-treatment intervals were 6-12 months (35%) and 12-24 months (38%). Cumulative dose and treated volume were identified as key decision-making parameters by most participants (94%). Major challenges included cumulative dose estimation (90%), concerns regarding toxicity (80%), the lack of standardised guidelines (56%), and limited access to advanced planning tools, including deformable image registration. EQD2 was systematically used for biological dose summation by all respondents. This first multicountry assessment from the MENA region reveals considerable variability in re-irradiation practices and underscores gaps in infrastructure, standardisation, and training. These results highlight the need for region-specific guidelines and collaborative efforts to optimise safe and consistent re-irradiation approaches.
SN  - 1507-1367
SN  - 2083-4640
ER  -