Deep Dive on Palliative Care
Prognostication is one of the most difficult tasks that radiation oncologists face. Traditionally, patients with metastatic cancer have had poor life expectancies on the order of weeks to months. However, in the era of immunotherapy and data showing a potential survival advantage for locally ablative radiation (SABR-COMET, STAMPEDE), a small percentage of patients are becoming long term survivors, making the task of prognostication even both more difficult as well as more important. While immunotherapy and stereotactic radiation are promising for those who respond, it is difficult to predict exactly who these responders will be. Conversations with patients must therefore balance hope with realistic expectations.
This case-based course aims to educate on the current status of prognostic tools and how these can be applied in this modern era. It will also educate on communication techniques surrounding prognostication with these new therapies, as well as treatment decision making.
This activity is available from October 1, 2021, through 11:59 p.m. Eastern time on September 30, 2024.
This activity is designed to meet the interest of radiation oncologists, radiation therapists and radiation dosimetrists.
Upon completion of this activity, learners should be able to do the following:
- Discuss patterns of radiation delivery at the end of life.
- Distinguish the different eligibility requirements of trials that have defined the oligometastatic paradigm in lung cancer.
- Describe the indications for palliative thoracic radiation and the rates of success.
- Provide an update on radiotherapy for brain metastases.
- List prognostic tools that predict outcomes for patients with spine metastases.
- Describe some communication techniques that can help clinicians talk with patients about spine metastases.
- Utilize an algorithm for creating a treatment plan for patients with spine metastases.
Michael Yu, MD is employed at Moffitt Cancer Center and receives compensation from UpToDate. Dr. Yu has investment interest from Novocure, Abbvie, BrainLab and BMS.
Candice Johnstone, MD is employed at Medical College of Wisconsin and has no financial relationships with a commercial interest.
Joshua Jones, MD is employed a the Department of Radiation Oncology, University of Pennsylvania and has no financial relationships with a commercial interest.
The person(s) above served as the developer(s) of this activity. Additionally, the Education Committee had control over the content of this activity. All relevant relationships have been mitigated.
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.
- 2.25 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 for a maximum of 2.25 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 2.25 self-assessment credits.
ASTRO members must log in to the ASTRO website to view and receive the discounted member rate.
- Nonmember: $99
- Member: $70
No refunds, extensions, or substitutions will be made for those participants who, for any reason, have not completed the course by the end of the qualification date. The qualification date for each course is listed in the course catalog on the ASTRO website under availability.
Participants using ASTRO's online courses to satisfy the requirement of a Maintenance of Certification (MOC) program should verify the number, type and availability dates of any course before making a purchase. No refunds, extensions, or substitutions will be made for participants who have purchased courses that do not align with their MOC requirement.
The course and its materials will only be available on the ASTRO website for that 3 year period regardless of purchase date. At the expiration of the qualification, participants will no longer have access to the course or its materials. ASTRO reserves the right to remove a course before the end of its qualification period.
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