Palliative Re-Irradiation

Palliative radiotherapy (RT) is a foundation of the discipline and practically represents a significant portion of most practices. The standard protocols for palliative RT (8Gy x 1, 4Gy x 5, etc.) were pioneered almost 50 years ago, when systemic therapies were far less useful. Thus, patients may live long enough to recur after RT. Our technology has made image guidance and large doses per fraction very common. Many of us retreat lesions without thinking much about the construct. This could be dangerous. This panel discusses frankly where the data for this practice exist, and where they do not. They also discuss the landmark ESTRO/EORTC consensus document published in October 2022 in Lancet Oncology.

Topics:

  1. Retreatment of Bone Metastases for Pain
    Edward Chow, PhD, MBBS, MSc., FRCPC
  2. Reirradiation: ESTRO/EORTC Consensus
    Peter Hoskin, MD
  3. Re-Re-Irradiation (Third Course) - Extracranial with Palliative Intent
    Emily Keit, MD, MS
  4. Retreatment of the Spine and CNS
    Dirk Rades, MD, FASTRO

This activity is available from January 16, 2024, through 11:59 p.m. Eastern time on January 15, 2026. 

This activity was originally recorded at the 2023 ASTRO Annual Meeting as an ASTRO/SPRO joint session. 

Target Audience

The activity is designed to meet the interests of radiation oncologists and physicists. 

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Discuss the findings of the landmark ESTRO/EORTC consensus statement on re-irradiation with respect to palliation. 
  • Identify the limited areas where clinical trial data exist on palliative re-irradiation.
  • Explain the nuances to be considered in re-re-irradiation for cancer symptom palliation. 
Course summary
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 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 Attendance
    This activity was designated for 1.00 AMA PRA Category 1 Credit™.
Course opens: 
01/16/2024
Course expires: 
01/15/2026
Cost:
$0.00
Rating: 
0
  • Stephen Thomas Lutz, MD, FASTRO, is employed by Eastern Woods Radiation Oncology.   
  • Peter Hoskin, MD, is employed by University of Manchester, NHS England.
  • Dirk Rades, MD, FASTRO, is employed by University of Lubeck, Germany and by University Medical Center Schleswig-Holstein, Germany. Dr. Rades receives research funding for trials from the European Regional Development Fund. 
  • Edward Chow, PhD, MBBS, MSc., FRCPC, is employed by Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto.
  • Emily Keit, MD, BS, is employed by Moffitt Cancer Center.  

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.

Disclosure link: 
Committee Disclosures

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. 

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 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 Attendance
    This activity was designated for 1.00 AMA PRA Category 1 Credit™.

Price

Cost:
$0.00
Please login or register to take this course.

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/Grad Student/PGY: $49
Postdoctoral Fellow: $49
 

Policies:
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 until January 15, 2026, 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.

Required Hardware/software

One of the two latest versions of Google Chrome, Mozilla Firefox, Internet Explorer or Safari.