Magnetic Resonance Imaging (MRI) Guided Stereotactic Adaptive Radiotherapy for Targeting Abdominal Cancer

Inclusion Criteria

• •Aged 18 years or older
• •Patients with diagnosis of oligometastatic disease from primary colorectal, upper gastrointestinal (e.g. gastric, oesophagus, pancreatic), breast, non-small cell lung, renal cell, or gynaecological malignancy. Oligometastatic disease with controlled primary disease\* and maximum total of 5 metastatic lesions in a maximum of 2 different organ systems in any of the following sites:
• •1. Liver
• •2. Adrenal
• •3. Abdomino-pelvic lymph node
• •4. Other abdominal site e.g. pancreatic, renal.
• •5. Other pelvic site
• •6. Bony or lung is allowed only if in conjunction with an abdominal site above
• •De novo or metachronous oligometastatic disease where the original tumour site has been treated with curative intent.
• •* Controlled primary disease in metachronous oligometastastic disease defined as at least 3 months since original tumour treated with curative intent and no progression at primary site
• •* Controlled primary disease in de novo oligometastatic disease defined as primary tumour site treated with curative intent and no progression at primary site
• •Oligometastatic disease: Histological confirmation of primary malignancy (histological confirmation of metastasis is not mandatory but should be performed in any situation where there is any diagnostic uncertainty).
• •All oligometastatic sites treatable with SABR.
• •OR
• •Patients with oligo-progressive / oligo-persistent disease in maximum total of 2 oligo-progressive abdominal metastases and in a maximum 2 different organ systems
• •Visible imaging defined targets and suitable for treatment with SABR
• •Childs Pugh A to B7 (in case of liver treatment)
• •ECOG 0 -2
• •Patient consented