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Repeat Radiotherapy of the Brain and Spine: A Case-Based Review of Efficacy and Safety and How to Implement a Standardized Process
Radiotherapy or radiosurgery is the primary treatment for most patients with primary brain tumors and metastatic tumors of the brain and spine. With increasing overall survival for these patients, they are at an increasing risk of tumor recurrence within a previously irradiated field. In this case-based program of the now common scenario of evaluating a patient who may benefit from repeat irradiation in the brain or over the spinal cord, this activity reviews: 1. Repeat irradiation in the brain for common histologies, including glioblastoma and brain metastases, 2. Repeat irradiation of spine metastases, including review of spinal cord toxicity and "forgiveness" of past irradiation dose, and 3. The implementation of a systematic approach to the Special Medical Physics Consult process to standardize reirradiation in the clinic and to optimize safety. The moderator presents common clinical cases, followed by discussion from the speakers.
Topics:
- Repeat Irradiation of Brain Tumors
Louise Murray, MB, ChB, PhD - Re-irradiation of Spine Tumors
Scott G. Soltys, MD, FASTRO - Clinical Implementation of the Special Medical Physics Consult for Reirradiation
Kelly C. Paradis, PhD
Presented by Martha M. Matuszak, PhD - Q and A
Stephanie E. Weiss, MD, FASTRO - Moderator
Full Panel
This activity is available from July 28, 2025, through 11:59 p.m. Eastern time on July 27, 2027.
The content was originally presented and recorded at the 2024 ASTRO Annual Meeting.
Target Audience
The activity is designed to meet the interests of radiation oncologists, physicists, radiation dosimetrists and residents.
Learning Objectives
Upon completion of this activity, participants should be able to:
- Identify patients with brain or spinal tumors for whom repeat irradiation may be beneficial.
- Determine safe cumulative doses of multiple courses of radiotherapy to organs at risk such as the brain and spinal cord.
- Implement a re-irradiation process in the clinic to optimize safety of patients receiving repeat irradiation.
- Stephanie E. Weiss, MD, FASTRO, is employed by Fox Chase Cancer Center. Dr. Weiss owns stock in Pfizer, AstraZeneca and Regeneron. Dr. Weiss serves an uncompensated role as Vice Chair of Graduate Medical Education at Temple University Hospital.
- Louise Murray, MB, ChB, PhD, is employed by University of Leeds, Radiotherapy Research Group.
- Scott G. Soltys, MD, FASTRO, is employed by Stanford University. Dr. Soltys receives grant/research funding and honoraria from Novocure, Inc., Accuray, Inc. and Brainlab, Inc.
- Kelly C. Paradis, PhD, is employed by Michigan Medicine. Dr. Paradis receives honoraria from Varian Medical Systems
- Martha M. Matuszak, PhD, is employed by University of Michigan. Dr. Matuszak receives grant/research funding from Varian. Dr. Matuszak has a licensing and collaboration agreement with Fuse Oncology. Dr. Matuszak serves in uncompensated roles with the AAPM as a Member of the Board of Directors, and with MROQC as Co-Director. .
The person(s) above served as the developer(s) of this activity. Additionally, the ASTRO Education Committee had control over the content of this activity. All relevant financial relationships have been mitigated.
The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Available Credit
- 1.00 AMA PRA Category 1 Credit™
The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education for physicians. ASTRO designates this Enduring material for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
- 1.00 Certificate of AttendanceThis activity was designated for 1.00 AMA PRA Category 1 Credit™.
Price
Course Fees:
ASTRO members must log in to the ASTRO website to view and receive the member rate.
- Nonmember: $149
- Member: $99
- Member-in-Training: $49
- Student/Graduate Student/PGY-1 Member: $49
- Postdoctoral Fellow Member: $49
If you are an ASTRO member from a low or lower-middle income country, as identified by the World Bank, you can receive a 50% discount off your corresponding registration for this activity. Please email [email protected] to inquire about the discount.
Policies:
No refunds, extensions, or substitutions will be made for those participants who, for any reason, have not completed the activity by the expiration date.
Participants using ASTRO Academy activities to satisfy the requirement of a Continuing Certification (MOC) program should verify the credit number and type and availability dates of any activity before making a purchase. No refunds, extensions, or substitutions will be made for participants who have purchased activities that do not align with their MOC requirement.
The activity and its materials will only be available on the ASTRO website until July 27, 2027, regardless of purchase date. At the expiration of the activity, participants will no longer have access to the activity or its materials. ASTRO reserves the right to remove an activity before its expiration date.
Required Hardware/software
One of the two latest versions of Google Chrome, Mozilla Firefox, Internet Explorer or Safari.