Simon Shek-Man Lo MD, Moderator: Research support, Elekta AB Speaker, Varian Medical Systems, Inc Travel support, Varian Medical Systems, Inc

1) Understand the role, eligibility criteria, expected treatment outcomes and toxicities of stereotactic ablative radiotherapy (SABR) for lung oligometastases. 2) Understand the role, eligibility criteria, expected treatment outcomes and toxicities of SABR for liver oligometastases. 3) Understand the role, eligibility, expected outcomes and toxicities of SABR for spinal oligometastasis. 4) Understand the role of interventional radiology in the management of oligometastases.

It has been a notion that once distant metastases occur, cancer is typically widely disseminated. Hellman and Weichselbaum from University of Chicago have proposed the state of oligometastasis where the metastatic disease is limited in number and site. There is clinical evidence to suggest that local aggressive therapy such as surgical resection may prolong survival and may even achieve a cure. Most recently, non-surgical therapies such as stereotactic ablative radiotherapy and image-guided ablative therapies for oligometastases have emerged, appearing to yield promising results based on multiple retrospective studies and single arm clinical trials. There are certainly controversies with regard to the use of local aggressive therapies for oligometastases. To establish this strategy as the standard of care for oligometastasis, a randomized controlled trial comparing  conventional care and local aggressive therapy would be ideal. The potential toxicities associated with these therapies have to be seriously considered before offering them to patients. Currently, there is an ongoing international randomized trial comparing SABR and conventional treatment enrolling patients in Canada and Europe and the results of this trial are eagerly awaited.  

Lo, S, Role of Stereotactic Ablative Radiotherapy (SABR) and Interventional Radiology in the Management of Oligometastases.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/13010639.html