Palliative Radiation Therapy for Spine Metastases

This presentation focuses on the management of spine metastases with palliative radiation, emphasizing a multidisciplinary and patient-centered approach incorporating up-to-date clinical practice guidelines and evidence. The NOMS (neurologic, oncologic, mechanical, systemic) framework is used to guide clinical decision-making about the utilization and optimal sequence of surgery, radiation, systemic therapies, and/or medications in the management of these patients. Treatment strategies for patients with painful spine metastases without epidural involvement as well as for patients with metastatic spinal cord compression are discussed, with a brief review of relevant literature on hypofractionated palliative external beam radiation regimens. Additionally, potential indications for stereotactic radiosurgery in select cases of oligometastatic, radioresistant, and/or previously irradiated disease are discussed

This activity is available from December 23, 2025, through 11:59 p.m. Eastern time on December 22, 2027. 

Target Audience

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

Learning Objectives

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

  • Develop a multidisciplinary and patient-centered approach to selection of treatment strategies for patients with spine metastases causing pain and/or neurologic compromise.
  • Understand evidence and potential indications for selection of spine metastasis-directed radiation techniques, including hypofractionation and stereotactic radiosurgery.
Course summary
Available credit: 
  • 0.75 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 0.75 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

  • 0.75 Certificate of Attendance
    This activity was designated for 0.75 AMA PRA Category 1 Credit™.
Course opens: 
12/23/2025
Course expires: 
12/22/2027
Cost:
$149.00
Rating: 
0

Speaker:

  • Subha Perni, MD, is employed by the University of Texas MD Anderson Cancer Center and has no relevant financial relationships to disclose.

Planners/Reviewers:

  • Michael Mattes, MD, is employed by Rutgers Cancer Institute. Dr. Mattes has research funding from Gilead Sciences [ended 8/30/2025].
  • Katie Hoffman is employed by the American Society for Radiation Oncology 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

  • 0.75 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 0.75 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

  • 0.75 Certificate of Attendance
    This activity was designated for 0.75 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 22, 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.