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Oncology›Clinical Question·Updated Jul 2, 2026·v1

Role of SBRT in Oligometastatic NSCLC [Opus]

For oligometastatic NSCLC (1 to 5 sites), SBRT to all disease is a guideline-endorsed metastasis-directed option (ASTRO/ESTRO, ISRS) added to systemic therapy. The strongest randomized evidence is in oligoprogression (CURB phase 2 RCT); de-novo oligometastatic and immunotherapy-combination data are mostly single-arm or early-phase. Reproducible benefit is high local control with acceptable toxicity; a definitive phase 3 overall-survival benefit is still pending, and SBRT is not standard for polymetastatic disease.

Moderate Evidence19 references·1,168 words·5 min read·v1
OncologyRadiation OncologyPulmonologyNSCLCOligometastatic diseaseSBRTSABRImmunotherapy
≈ Evidence Verdict — Mixed: Local control is consistently excellent and guideline-endorsed, but overall-survival benefit in oligometastatic NSCLC rests on single-arm and early randomized phase 2 data in the retrieved evidence, without mature phase 3 confirmation. Offer SBRT to well-selected oligometastatic NSCLC patients for durable local control alongside systemic therapy; counsel that a definitive survival advantage is still being established.
Framework: PICO

Board Review — High Yield

  • •The oligometastatic hypothesis holds that ablating all sites of limited metastatic disease can improve outcomes over systemic therapy alone.
  • •ASTRO/ESTRO conditionally recommend local therapy including SBRT for extracranial oligometastatic NSCLC.
  • •The current frontier is radioimmunotherapy: SBRT as an immune primer for checkpoint blockade.

Deep Dive — Evidence Details

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