Radiation for Non-Spine Bone Metastases

This presentation reviews the role of radiation therapy in the management of non-spine bone metastases, focusing on patient evaluation, treatment intent, dose selection, and integration with systemic and surgical care. It emphasizes that prognosis and goals of care, ranging from immediate pain palliation to durable control in limited disease, should guide therapeutic decisions. Typical patient workup includes clinical history, musculoskeletal and neurologic examination, and multimodality imaging to assess fracture risk and lesion characteristics. The talk discusses treatment scenarios such as postoperative irradiation after fixation, prophylactic palliation in high-risk asymptomatic lesions, oligometastatic disease, and radioresistant histologies, where SBRT may improve response durability. Toxicities, including pain flare, fracture risk, and long-term myositis, are reviewed, along with strategies for multidisciplinary management.

This activity is available from December 24, 2025, through 11:59 p.m. Eastern time on December 23, 2027. 

Target Audience

The activity is designed to meet the interests of medical oncologists, radiation oncologists, nurses, and residents.

Learning Objectives

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

  • Identify appropriate treatment intent (pain palliation, prophylactic stabilization, or durable control in limited disease) for various clinical scenarios of patients with non-spine bone metastases.
  • Select dose, fractionation, and technique for non-spine bone metastases, including when SBRT is preferred for ablation, radioresistant disease or reirradiation.
  • Incorporate multidisciplinary care, including orthopedic input, systemic therapy, bone-modifying agents, and supportive interventions in order to improve outcomes and patient quality of life.
Course summary
Available credit: 
  • 0.50 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 0.50 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

  • 0.50 Certificate of Attendance
    This activity was designated for 0.50 AMA PRA Category 1 Credit™.
Course opens: 
12/24/2025
Course expires: 
12/23/2027
Cost:
$149.00
Rating: 
0

Speaker:

  • Divya Yerramilli, MD, is employed by Memorial Sloan Kettering Cancer Center and has no relevant financial relationships to disclose.

Planner:

  • Michael Mattes, MD, is employed by Rutgers Cancer Institute. Dr. Mattes has research funding from Gilead Sciences [ended 8/30/2025].

Reviewer:

  • Michael Haddock, MD is employed by Mayo Clinic and has no relevant financial relationships to disclose.

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

  • 0.50 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 0.50 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

  • 0.50 Certificate of Attendance
    This activity was designated for 0.50 AMA PRA Category 1 Credit™.

Price

Cost:
$149.00
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/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 December 23, 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.