How do you approach a patient with NSCLC and 3 oligometastatic lesions that are 4-5 cm in muscles of the extremities?

This is a great question which I suspect will lead to a wide range of answers. My thought is that if the indication is strong enough (which could be iffy as these are likely poor prognosis metastatic sites) that I would proceed with SBRT in this setting - the strongest factors in my decision of SBRT...

I will not chime in on the medical rationale for locally aggressive therapy in an oligometastatic lesion in soft tissue/muscle, as this indeed could be an indicator of disease aggressiveness and it's hard to know if there will be a long-term benefit. Certainly, it's plausible.

However, if one has al...

I am skeptical this will be a good idea for the patient to offer SBRT given this presentation is atypical and not representative of an oligomet scenario that would more typically benefit from SBRT, but rather indicative of unusually aggressive disease with poor near term prognosis. My inclination wo...