Stereotactic body radiotherapy for oligometastases

Area of Science:

• Oncology
• Radiation Oncology
• Medical Physics

Background:

• Metastatic solid tumour management traditionally relies on palliative systemic treatments.
• Radical surgical management of oligometastases is increasingly adopted.
• Advancements in radiotherapy enable ablative doses to extracranial sites.

Purpose of the Study:

• To review the efficacy and safety of stereotactic body radiotherapy (SBRT) for oligometastatic disease.
• To assess the impact of SBRT on local control and progression-free survival.
• To evaluate the potential of SBRT in altering the natural history of oligometastatic cancer.

Main Methods:

• Review of published non-randomized studies on SBRT for oligometastases.
• Analysis of local control rates and progression-free survival data.
• Assessment of SBRT's role in non-liver, non-lung oligometastatic disease.

Main Results:

• SBRT demonstrates safety and effectiveness for oligometastases, achieving local control rates around 80%.
• Studies suggest SBRT may alter disease natural history, with 2-5 year progression-free survival around 20%.
• SBRT provides durable local control and potential progression-free survival across various non-liver, non-lung sites.

Conclusions:

• SBRT is a promising treatment for oligometastatic disease, aiming for local control and delayed progression.
• While cure may be possible for a few, SBRT's primary goal is to extend progression-free survival and postpone further treatment.
• Randomized trials are crucial to definitively establish SBRT's benefit in improving progression-free survival for oligometastatic cancers.