Curative Oligometastatic Radiation Therapy: Why We Should Redefine Intent When Cure May Be Attainable

Hellman and Weichselbaum proposed the oligometastatic disease (OMD) state in their seminal editorial “Oligometastases” in 1995, reasoning that malignancy exists along a spectrum from localized to widely-disseminated disease, with OMD existing in a restricted middle state in which cure or extended disease-free survival may still be attainable.1 Since the dual presentations of SABR-COMET and the oligometastatic non-small cell lung cancer phase II randomized control trials at the American Society for Radiation Oncology 2018 annual meeting, the paradigm for offering local radiotherapy (RT) for OMD has very rapidly evolved, greenlighting numerous trials, including phase III trials.