This study analyzed 242 patients treated with PT-ReRT. Median follow-up was 12.0 months for all patients and 24.5 months for living patients. Median PT-ReRT dose was 70 GyE for the fractionated cohort and 44.4 GyE for the quad shot cohort. For the fractionated cohort, the 1-year LC was 71.8% and OS was 66.6%. For the quad shot cohort, the 1-year LC was 61.6% and OS was 28.5%. Higher Karnofsky performance status scores (hazard ratio [HR], 0.50; 95% CI, 0.25-0.99; P = .046) and receipt of salvage surgery prior to PT-ReRT (HR, 0.57; 95% CI, 0.39-0.84; P = .005) were associated with improved OS, whereas receipt of quad shot (HR, 1.97; 95% CI, 1.36-2.86; P < .001) was associated with worse OS. There were a total of 73 grade 3 and 6 grade 4 early toxic effects. There were 79 potential grade 3, 4 grade 4, and 5 grade 5 late toxic effects. The authors concluded that this cohort study suggested that, compared with previous reports with photon-based reirradiation, patients are living longer with aggressive PT-ReRT.