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Medicine Grand Rounds - Palliative Radiotherapy: Old Lessons and Current Controversies

Dr. Kapedia provides an overview of terminology and technology used in radiation oncology, targeting a general medical audience. He articulates the intended use of palliative radiotherapy to relieve suffering and not to be curative. He describes the evidence supporting a variety of combined therapies used to treat bone and brain metastases, and spinal cord compression. When striving for maximum symptom relief using new and classic therapies Dr. Kapedia explores controversies, including strength and frequency of radiation treatments, side effects, efficacy and profit motive.

Activity Details

Start Date:   May 31, 2019
End Date:  May 31, 2021

You may claim CME credit for successful completion of this online course. In order to claim credit, you must follow these steps:

  1. Register for the learning activity by creating an account or logging in to your account.
  2. Click Continue to navigate to the Activity Material tab. Click View Presentation to view the recording.
  3. Return to this Activity page.
  4. Click Continue to navigate to the Evaluation tab; then click the Launch button to start the evaluation.
  5. Complete and Submit the evaluation and attestation form.

When the evaluation is submitted, you will be awarded credit. You may access your transcript for verification of participation at any time via Your Account. Need help? Visit the Support Page, send an Email, or call the Center for Learning and Professional Development at (603) 653-1234, Option 1.

  • Nirav S. Kapadia, MD, MS
    Medical Director, Norris Cotton Cancer Center North
    Assistant Professor of Medicine, Section of Radiation Oncology
    Assistant Professor of The Dartmouth Institute for Health Policy and Clinical Practice
    The Geisel School of Medicine at Dartmouth

    Dr. Nirav Kapadia earned his AB in Biophysical Chemistry at Dartmouth College, his MD at the Johns Hopkins University School of Medicine, and completed his clinical training in internal medicine and radiation oncology at the University of Michigan. He is a full time staff physician with research and administrative interests focused on value creation in health care delivery, by focusing on intersection between quality improvement and health services research.
Learning Outcome

Participants will be able to discuss classical literature and current controversies around radiotherapy in the treatment of bone and brain metastases, as well as spinal cord compression.


Dartmouth-Hitchcock is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Dartmouth-Hitchcock designates this enduring material for a maximum of 1 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Requirements for Successful Completion

In order to receive credit for this Continuing Medical Education (CME) activity, you must:

  • View the entire presentation
  • Complete the online Attestation of Attendance & Evaluation Form (you must register to access).

In accordance with the disclosure policy of Dartmouth-Hitchcock/Geisel School of Medicine at Dartmouth as well as standards set forth by the Accreditation Council on Continuing Medical Education and the Nursing Continuing Education Council standards set forth by the American Nurses Credentialing Center Commission on Accreditation, continuing medical education and nursing education activity director(s), planning committee member(s), speaker(s), author(s) or anyone in a position to control the content have been asked to disclose any financial relationship* they have to a commercial interest (any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on patients). Such disclosure is not intended to suggest or condone bias in any presentation, but is elicited to provide participants with information that might be of potential importance to their evaluation of a given activity.

The following Activity Physician Director(s), planning committee member(s), speaker(s), author(s) or anyone in a position to control the content for Palliative Radiotherapy: Old Lessons and Current Controversies (Medicine Grand Rounds) have reported the following financial interest or relationship* with various companies/organizations. The Activity Director and Planning Committee member roles were resolved by altering the individual’s control over content about the products or services of the commercial interest by the Associate Dean for CME and the Department of Medicine Chair. All potential conflict(s) were resolved.

* Kelly Kieffer, MD ~ her spouse is a consultant for OcculoBio. 

* Richard I. Rothstein, MD ~ has research support from Baranova (research grant to Dartmouth-Hitchcock Medical Center) and has other financial interest from Allurion. 

Other planning committee member(s), speaker(s), activity director(s), author(s) or anyone in a position to control the content for this program report no financial interest or relationship* with any company(ies) or organizations whose product may be germane to the content of their presentations.

*A “financial interest or relationship" refers to an equity position, receipt of royalties, consultantship, funding by a research grant, receiving honoraria for educational services elsewhere, or to any other relationship to a company that provides sufficient reason for disclosure, in keeping with the spirit of the stated policy.

Provider Contact Information

Provider contact information for questions regarding accreditation of the activity:

Center for Learning and Professional Development
Dartmouth-Hitchcock Medical Center

Type:     Internet Activity (Enduring Material)
8 Registered Users