Application of Radiotherapy in Oligometastatic Disease Publisher



Kolahdouzan K ; Ghalehtaki R ; Abyaneh R ; Counago F
Source: From Radiobiology to Radiation Oncology Published:2025

Abstract

Oligometastatic disease (OMD) represents an intermediate state between localized and widespread metastatic cancer, characterized by limited metastatic foci. This chapter explores the application of radiotherapy, particularly stereotactic ablative radiotherapy (SABR), in managing OMD. SABR delivers high and precise radiation doses to metastatic sites, offering potential survival benefits, improved progression-free survival (PFS), and delayed need for initiating or changing systemic therapies. The chapter reviews the rationale for radiotherapy in OMD, emphasizing advancements in imaging, treatment planning, and delivery techniques, such as adaptive radiotherapy (ART) and MR-guided radiotherapy (MRgRT), which enhance precision and minimize toxicity. Patient selection is critical, with factors such as metastasis number, location, and tumor biology guiding treatment decisions. Clinical applications of radiotherapy in non-small cell lung cancer, prostate cancer, and breast cancer are discussed, highlighting the role of SABR in improving outcomes. However, challenges remain, including the lack of standardized definitions and protocols for OMD. The chapter underscores the need for further research, particularly prospective randomized trials and biomarker studies, to refine patient selection and treatment strategies, ultimately improving the therapeutic ratio and quality of life for patients with OMD. © 2025 The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG.