Role of SRS/SBRT in Oligometastatic Disease

Oligometastatic disease represents an intermediate state between the early localized disease and widespread metastatic malignancy. Some patients with oligometastatic disease, treated by ablative treatments to all sites of metastatic disease, can achieve long disease-free survival and sometimes cure. Stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) are accepted treatment options for these patients, achieving high rates of local control. While most of the studies report outcomes of SBRT for solitary oligometastasis, patients with oligometastatic disease might present multiple concurrent lesions either in the same organ or in neighboring organs. There are few studies addressing the role of SBRT in patients with multiple concurrent oligometastases. Furthermore, these patients likely recur either in the same organ or at distance. Therefore, the need for retreatment with SBRT might be required. There remains a dearth of data regarding the re-irradiation after prior SBRT, toxicity and dose volume constraints.

Particularly as it related to significant improvements in systemic therapies (including immunotherapies), it is likely that the number of patients presenting with induced oligometastases will increase. While targeted, immune therapies and SBRT are increasingly used in patients with oligometastatic disease, their sequencing, interaction, and toxicities have not been studied and are poorly understood.

We are inviting submission of papers reporting treatment options, outcomes, and toxicities in patients with oligometastatic disease, especially in the context of multiple oligometastases, re-irradiation after prior SBRT and for patients undergoing new systemic treatments.