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In this issue of Cancer insights, specialists discuss a multidisciplinary approach to stereotactic radiosurgery for spine metastases, stereotactic body radiation therapy in head and neck cancers, and current clinical trials.

Educational objectives:

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

  • Increase awareness of modern re-irradiation techniques available for treatment of patients with recurrent head and neck cancer 
  • Increase awareness of modern systemic agents in recurrent head and neck cancer
  • Update the ongoing national efforts to improve outcomes in head and neck cancer 
  • Better recognize the expected rates of pain relief at 1-year for long term survivors with bone metastases may be suboptimal and identify such patients for other treatment strategies
  • Identify patients who may benefit from novel therapies such as SRS having failed prior conventional palliative measures
  • Identify patients who may benefit from novel treatment approaches for cord compression after failing prior conventional treatment strategies

Reading Resources:

1. Heron DE, Ferris RL, Karmouzis M, et al.  Stereotactic body radiotherapy for recurrent squamous cell carcinoma of the head and neck: results of a phase I dose-escalation trial.  Int J Radiat Oncol Biol Phys 2009;75:1493-1500.
2. Vargo JA, Ferris RL, Ohr J, et al. A Prospective Phase II Trial of Re-irradiation with Stereotactic Body Radiotherapy plus Cetuximab in Patients with Recurrent Previously-Irradiated Squamous Cell Carcinoma of the Head and Neck.  Int J Radiat Oncol Biol Phys 2015;91:480-8.
3. Seiwert T, Haddad R, Gupta S.  Antitumor activity and safety of pembrolizumab in patients (pts) with advanced squamous cell carcinoma of the head and neck (SCCHN) (2015) preliminary results from KEYNOTE-012 expansion cohort. J Clin Oncol 2015;33s:LBA6008.
4. Wong SJ, Heron DE, Stenson K, Ling DC, Vargo JA. Locoregional Recurrent or Second Primary Head and Neck Cancer: Management Strategies and Challenges. Am Soc Clin Oncol Educ Book 2016;35:e284-92.
5. Bone Pain Trial Working Party.  8 Gy single fraction radiotherapy for the treatment of metastatic skeletal pain: randomised comparison with a multifraction schedule over 12 months of patient follow-up.  Radiother Oncol 1999;52:111-21.
6. Ryu S, Jin R, jin KY, et al.  Pain control by image-guided radiosurgery for solitary spinal metastasis.  J Pain Symptom Manage  2008;35:292-8.
7. Ryu S, Jain R, Lu M, et al.  Radiosurgical decompression of metastatic epidural compression.  Cancer 2010;116:2250-7


Doctors Gebhardt, Ferris, Heron, Amankulor, Horne, Engh, Ohr, and Ms. Quinn report no relevant relationships with any entities producing health care goods and services.

Dr. Vargo reports CE Speakers’ Bureau for BrainLab Spine SRS Circle ASTRO 2016, Boston, Mass.

All presenters disclosure of relevant financial relationships with any entity producing, marketing, re-selling, or distributing health care goods or services, used on, or consumed by, patients is listed above.  No other planners, members of the planning committee, speakers, presenters, authors, content reviewers and/or anyone else in a position to control the content of this education activity have relevant financial relationships to disclose.

Accreditation Statement:

The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The University of Pittsburgh School of Medicine designates this enduring material for a maximum of .5 AMA PRA Category 1 Credits™. Each physician should only claim credit commensurate with the extent of their participation in the activity. Other health care professionals are awarded (0.05) continuing education units (CEU) which are equivalent to .5 contact hour.

For your credit transcript, please access our website 4 weeks post-completion at and follow the link to the Credit Transcript page. If you do not provide the last 5 digits of your SSN on the next page you will not be able to access a CME credit transcript. Providing your SSN is voluntary.

Release Date: 12/30/16 | Last Modified On: 12/30/164 | Expires: 1/1/2018

This course has been expired.