4.5 Article

The oligometastatic paradigm and the role of radiotherapy

Journal

CLINICAL MEDICINE
Volume 23, Issue 1, Pages 61-64

Publisher

ROY COLL PHYS LONDON EDITORIAL OFFICE
DOI: 10.7861/clinmed.2022-0559

Keywords

oligometastatic; oligoprogression; metastasec-tomy; SABR; RFA

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Most cancer-related deaths are caused by metastatic disease. Evidence suggests that a subgroup of metastatic patients can benefit from local resection or ablation of their metastatic sites. These patients are in an oligometastatic state, where locally ablative therapy prolongs survival and sometimes achieves cure. It is a challenge for oncologists to select the appropriate patients and integrate ablative technologies with systemic treatments.
Most cancer-related deaths are due to metastatic disease. There is now an emerging evidence base suggesting that a subgroup of metastatic patients benefit significantly from local resection (surgery) or ablation (stereotactic ablative body radiation, SABR) of their metastatic sites. These patients are in what has been termed theoligometastatic state, a transitional window between local and disseminated disease where locally ablative, metastasis-directed therapy prolongs progression-free survival, improves overall survival and sometimes achieves cure. Appropriately selecting those who fit this oligometastatic phenotype, while integrating advances in ablative technologies such as SABR with modern systemic treatments, is an evolving challenge for oncologists.

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