In recurrent or metastatic disease, the goal is usually disease control and quality of life. In Japan, particle therapies, catheter-based regional treatments, immunotherapy and personalized vaccines are evaluated in this setting.
In oligometastatic (limited spread) disease, targeted local treatment with heavy ion/proton may be discussed.
Catheter-based regional therapies (IGT) and hyperthermia are incision-free options.
Personalized vaccine (AFTV) and immunotherapy are protocols aiming to support systemic control.
Realistic expectations and honest conversation are essential here; no method is presented as a 'last chance'.