AM2019 EDU27 Stereotactic Body Radiation Therapy for Solid Tumor Spinal Metastases: A Practical Case Based Discussion
In this practical, case based educational session we will review fundamental elements of spine SBRT by reviewing 3 specific case scenarios:
- SBRT in a patient with a radio-resistant primary tumor histology and oligo-metastatic disease
- SBRT in the re-irradiation setting
- SBRT in the post-operative setting
For each case we will review the relevant NOMS framework for evaluating patients with spine metastases including neurologic, oncologic, mechanical, systemic factors. In addition, for each case a radiologist will review the images and relevant clinical pearls such as differentiating tumor from non-malignant etiologies such as hemangiomas and Schmorl’s nodes. Furthermore, we will review consensus contouring guidelines and apply them to each case. Finally, we will review clinical outcomes and toxicity data as they pertain to each case.
The fundamental concepts and controversies to be addressed for each of the 3 cases outlined above include:
- Evaluation of candidacy for SBRT and surgery using Neurologic, Oncologic, Mechanical, Systemic (NOMS) framework
- Evaluation of pre-treatment and follow-up MRIs by a board certified neuro-radiologist including both clinical pearls and application of the Bilsky epidural grading system
- Basic principles of spine SBRT including target/normal tissue delineation and treatment planning
- Normal tissue tolerances
- Local control and toxicity following spine SBRT including examples of toxicity that pertain to each of the 3 cases
Please note that the structure of the proposed session will be unique from historical educational sessions. Each speaker will discuss a specific element of each of the 3 cases outlined above.
The meeting is designed to meet the interests of medical oncologists, radiation oncologists, surgeons, radiation physicists, nurses, radiation therapists, radiation dosimetrists, residents, and specialists.
- Apply assessments of neurologic function, epidural grading, and spinal stability to clinical decision in the management of patients with spine metastases.
- Evaluate spine MRIs for the extent of tumor involvement and identify common non-malignant etiologies such as hemangiomas and Schmorl’s nodes.
- Describe SBRT radiation technique, including delineation of the optimal target volume, spinal cord delineation, and toxicities in 3 clinical scenarios including 1) oligometasatic spine disease; 2) post-operative spine SBRT; 3) re-irradiation.
The following persons served as faculty for this activity:
Behrang Amini, MD, PhD is employed at MD Anderson Cancer Center and has nothing to disclose.
Amol Ghia, MD is employed at MD Anderson Cancer Center receives compensation/remuneration/funding from BrainLab and Elekta.
Raju Raval, MD, DPhil is employed at Arthur G. James Hospital/Ohio State Comprehensive Cancer Center and has nothing to disclose.
Kristin J. Redmond, MD, MPH is employed at Johns Hopkins University School of Medicine and receives compensation/remuneration/funding from Accuray, AstraZeneca and Elekta AB.
Additionally, the Education and CME/MOC Committee had control over the content of this activity.
The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council of Continuing Medical Education to provide continuing education to physicians.
ASTRO is awarded Deemed Status by the American Board of Radiology to provide SA-CME as part of Part II Maintenance of Certification.
- 1.25 SA-CME
The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council of Continuing Medical Education to provide continuing medical education for physicians.
The American Society for Radiation Oncology (ASTRO) designates this Live activity for a maximum of 1.25 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
This activity meets the American Board of Radiology's criteria for a self-assessment activity in the ABR's Maintenance of Certification program. Participation in this course in combination with the successful completion of the corresponding assessment and course evaluation adheres to the guidelines established by the ABR for 1.25 self-assessment credits.
- 1.25 Certificate of AttendanceThis activity was designated for 1.25 AMA PRA Category 1 Credit™.
- No refunds, extensions or substitutions will be made for those registrants who, for any reason, were unable to attend or were tardy for the session.
- No credits will be granted and no refunds, exchanges or transfers will be given to those who do not pass.
- ASTRO staff cannot make modifications to your submitted materials.
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