How do you treat non-spine bone oligometastases?

1. Get the MRI. It is proven to reduce inter-observer variability in contouring (Raman et al., PMID 29748100). More philosophically, sometimes you'll see something more, sometimes you won't. But the only way to know is to check. And if this treatment is worth doing, it's worth doing accurately -- espe...

Just some thoughts from a non-expert.

My preference for non-spine is 30 in 3 (BED10 of 60). I see 30 in 5 often, but that feels "wimpy" (BED10 of 48). If preference is 5 fx (which is prevalent in community practice), then 35 in 5.

I don't love a single fraction. I don't have evidence for it, but I t...

Minimum BED for ablation is approximately 100, and 50 Gy in 5 fractions achieves this for a rib lesion. Beware of rib fx risk of 10-20%. In other areas, be aware of neural toxicity. May need to lower the BED expectation.