In-room imaging and MR planning

Rationale for “ablative” radiotherapy of (oligo)M+

1. Conventional RT is not adequate for metastatic patients with expected long survival (e.g. patients with “favorable” histology, good KPS, and ≤ 3 metastases). Higher doses are required for long-term local/pain control.

2. Radical intervention delivered during an “oligometastatic” phase could change disease progression in patients who would otherwise have been treated palliatively.

3. Because SABR potentially works through direct cell killing, its use should be considered in metastases of primary tumors generally considered “radioresistent” (e.g. renal cell cancer or melanoma), even for short-term palliation.

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