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October 15, 2020

Metastatic Disease as a Distinct Discipline in Radiation Oncology

Author Affiliations
  • 1Precision Radiation for Oligometastatic and Metastatic Disease (PROMISE) Program, Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
JAMA Oncol. Published online October 15, 2020. doi:10.1001/jamaoncol.2020.1824

The treatment paradigm for patients with metastatic cancer has shifted in the era of oligometastatic disease,1 novel systemic therapy, and local ablative therapy options such as stereotactic ablative body radiotherapy (SABR). The equation of “metastatic” with “incurable” has been challenged, as an increasing number of patients with stage IV disease have long-term survival outcomes. In the treatment of oligometastasis, several clinical trials have recently demonstrated the survival benefits of SABR.2-4 For patients with diffuse metastatic disease or those who are otherwise being treated with palliative intent, the optimal radiation technique has also been a subject of scrutiny.5 To this end, in 2016 the Department of Radiation Oncology at Memorial Sloan Kettering Cancer Center established a dedicated program for patients with metastatic cancer to address the specific needs of these patients, the Precision Radiation for Oligometastatic and Metastatic Disease, or PROMISE, Program.

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