When is it appropriate to recommend SBRT directed to sites of oligometastasis (ex, single adrenal met) for a patient with extensive stage small cell s/p chemo and PCI?

May I play devil's advocate for one moment? I don't wholly disagree with @Dr. First Last btw, fwiw.

1) Some people with SCLC can be cured. It appears that the application of a local therapy in limited stage SCLC increases the chance for long-term DFS (aka "a cure"). Five-year survival was doubled fro...

Unlike NSCLC, true oligometastatic small cell lung cancer is rare. In fact, I'm not sure if I really believe there is such an entity. This disease entity is basically extrapolated from NSCLC data. Giuliani did a review specifically to determine the effect of consolidative thoracic radiotherapy in pa...

I've had this exact case in practice. Multiple lines of therapy were tried at med onc, but eventually the patient needed SBRT as there was clear progression at the adrenal despite IO and second-line chemo.

The patient underwent 5 fx SBRT and has been in a CR for over two years, last I had heard.

1) Based on outcomes from radiation therapy alone studies and limited surgical series, I feel comfortable saying that very few "limited stage" SCLCs are truly localized at presentation, since most patients will fail distantly if no chemotherapy is given. Thus, we should assume that every patient has...