Clinical experience has shown that metastasis can often be limited in number and location,
and thus amenable to local treatment. The term oligometastasis describes an intermediate
state of cancer spread between localized disease and widespread metastasis. The implication
of such an intermediate state is that the disease can be cured by using metastasis-directed
therapy. Historically, in some patients with oligometastases in the liver or lungs, surgical
resection was often indicated, as abundant evidence suggested it could improve
progression-free or overall survival. Recently, several studies have reported promising
outcomes of >80% local control with Stereotactic Body Radiotherapy (SBRT) in patients with
lung or liver oligometastases. Nonetheless, very few studies have focused on non-liver,
non-lung extracranial oligometastatic lesions treated with SBRT, and such studies have
limitations of a retrospective nature and small sample sizes.Because allmost studies are
based on single-arm studies without appropriate controls, the level of evidence to support
SBRT is weak. Randomized trials are therefore necessary to establish the utility of SBRT for
oligometastatic disease.
This study is designed as a randomized phase II study. Patients will be randomized between
current standard treatment (Arm 1) versus standard treatment +SBRT (Arm 2) to all known
disease.