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:
- Retreatment of Bone Metastases for Pain
Edward Chow, PhD, MBBS, MSc., FRCPC - Reirradiation: ESTRO/EORTC Consensus
Peter Hoskin, MD - Re-Re-Irradiation (Third Course) - Extracranial with Palliative Intent
Emily Keit, MD, MS - 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.
- 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 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 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/Grad Student/PGY: $49
Postdoctoral Fellow: $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 January 15, 2026, 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.