What is your thought process for dose prescriptions when treating abdominal/pelvic lymph node oligometastasis with SBRT?

I don't love SBRT for nodal mets aside from unique situations. Although I agree they may represent a less aggressive phenotype than hematologic parenchymal mets they are also connected to their neighbors in a way a bone met isn't. SBRT is a very focal therapy when done well and so neighboring LNs do...

In oligometastatic disease, LN metastases are generally thought of as relatively favorable prognosis-same category as bone mets (worst prognosis would be adrenocortical and brain). If that is the case, I would favor more aggressive dosing for a solid tumor primary—in the case of a lymphoma, for exam...

I agree with the previous thoughtful responses from Drs. @Dr. First Last and @Dr. First Last. Two other points i'd like to build on:

1. Patient selection.

We shouldn't treat LNs with SBRT just because we can. Need to consider:

patient factors (anything that increase risk? ILD/IPF for intrathoracic...

To add to the prior excellent comments, I agree that with nodal metastases one may need to be more concerned about micrometastases in the adjacent tissues (nodes) than perhaps with other sites of oligometastases. I've had good tolerance and long term disease free survivals with a dose painting appro...

Here is our data on reradiation for node for gyne cancer.