Oligometastatic disease and remote stereotactic body ablative radiotherapy. Part I. Non-small cell lung cancer

Patients with non-small cell lung cancer and distant relatively limited metastasis process are currently defined as patients with oligometastatic disease (OMD), if possible local ablative, including radiation therapy of all metastatic lesions can be radically implemented with the lowest radiation toxicity against the background of controlled primary malignancy. Data from various series of clinical retrospective studies suggest that patients with OMD have a better prognosis compared with other patients with stage IV disease. However, most clinical trial reports include patients with varying numbers of metastases at different anatomical sites who received different invasive and non-invasive antitumor therapies. Therefore, although further results of randomized clinical trials on the use of adequate therapeutic tactics in oligometastatic non-small cell lung cancer, including the use of remote stereotactic ablative body radiotherapy (RSABR), are awaited, the decision on the specific treatment of this category of patients should be justified on the basis of multidisciplinary discussion on a case- by-case basis. Both surgery and radiation therapy should play a dominant role in determining the specific course of treatment, while providing the opportunity for curative-targeted local therapy in combination with systemic antitumor therapy. This review is a continuation of a series of reviews on the current status of the role of RSABR in OMD. In the first signal report on this problem (Vestnik RSCRR. 2023. Vol. 23, No. 3) general issues related to the use of RSABR in patients with OMD were highlighted. In subsequent publications it is planned to evaluate the current state of the issue of RSABR implementation already in different localizations of oligometastatic tumor process, and the cycle of reviews begins with the coverage of the role of RSABR in patients with oligometastatic non-small cell lung cancer.