Primary tumor recurrence remains a challenge to treat after high-dose thoracic radiation for early-stage or locoregionally advanced non-small cell lung cancer (NSCLC). 

Although stereotactic radiation offers excellent local control for early-stage NSCLC, there is a 10% risk of intralobar recurrence adjacent to or within a prior radiated volume. 

In patients with locally advanced lung cancer treated in the modern era with chemoradiation and consolidative immunotherapy, there is a 25% risk of intrathoracic recurrence. 

Often, these recurrences are not resectable, and nonoperative approaches are sought. An increasing body of literature has reported on the feasibility, safety, and outcomes of reirradiation with SBRT with the risk of this treatment depending greatly on location, degree of overlap with prior radiation fields, and the prior dose to adjacent organs at risk (OARs). 

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