This study aimed to examine the education and training needs of health care practitioners (HCPs) in the Philippines who encounter lung oligometastatic cancer patients. Lung oligometastatic disease is among the most common sites for cancer spread and has the most established practices for treating oligometastases. A modified version of the Hennessy–Hicks Training Needs Assessment Questionnaire was administered online to HCPs working in private and public centers in the Philippines. HCPs were recruited via purposive sampling. Twenty-seven HCPs completed the questionnaire (47% response rate). Respondents were mostly female (59%) and between the ages of 30 and 39 years (70%). Three-quarters (74%) were consultants, and most respondents were radiation oncologists (44%) or medical oncologists (30%). Medical oncologists rated Management/Supervisory Tasks (mean = 1.42) as their highest area of training need while radiation oncologists rated Clinical Tasks (mean = 1.30) as their highest training need. Pulmonologists (mean = 0.60) and other specialists (mean = 1.00) rated Administration tasks as their top area of training need. The clinical task-related category was rated the highest need among the continuing medical education topics. This study provides valuable insights for the implementation and advancement of a comprehensive curriculum in clinical oncology, specifically designed to enhance the administrative, clinical, and research capacities of oncologists who encounter oligometastatic lung disease in the Philippines.

Reirradiation is an increasingly common challenge with limited prospective evidence to guide practice, which varies internationally. This paper presents the patterns of practice in thoracic reirradiation within a high-volume academic center. Thoracic reirradiation cases, discussed at the thoracic radiotherapy quality assurance (QA) meeting, were prospectively collected over 12 months between April 2024 and March 2025. Data collected included patient demographics, primary tumor site, details of previous and current planned radiotherapy, the extent and type of overlap and any treatment plan modifications. The data was analyzed using descriptive statistics. 85 (18.2 % of 466 cases) reirradiation cases were identified at 26 QA meetings. Most reirradiation plans (68.2 %) were of radical intent, with dose overlap (89.4 %, n = 76). Challenges included unreliable registration of prior radiotherapy datasets (16.5 %) and deciding appropriate plan modifications to improve safety: 24.7 % optimized dose distribution to an OAR, 23.5 % involved dose reductions from standard prescriptions and 15.3 % compromised target volume coverage. The most frequently identified dose-limiting OARs were the proximal bronchial tree, esophagus, and spinal cord. Concerns about a lack of normal tissue recovery arose in 7.1 % of cases. In 10.6 % of cases there was explicit discussion of a dose discount for OARs for presumed partial tissue recovery. Peer-review prompted revision of the treatment plan in 11.8 % of cases. These findings underscore the complexity of thoracic reirradiation and highlight the need for further guidance in the area and the role of QA rounds in optimizing safety and treatment decisions while best practice remains uncertain.