Patients with Stage IV Lung cancer vary in their response to the numerous systemic therapies and are living longer. The role of aggressive local therapy or metastatic directed therapy (MDT) is critical for radiation oncologists and surgeons.

This activity reviews the various oligometastatic states, existing and upcoming data supporting radiation in appropriately selected patients, intersection of radiation with systemic therapy, and practical applications of radiation treatment delivery with a focus on stereotactic ablative radiation

SBRT for oligometastatic disease of mixed histologies has been shown to improve progression-free and even overall survival. A large cooperative group study recently demonstrated that there was no overall survival advantage seen when constrained to breast cancer alone.

There is a high degree of variability in the management and even the understanding of the oligometastatic state in lung malignancies, or indeed in the context of any solid tumor.