Magnetic Resonance Imaging (MRI) Guided Stereotactic Adaptive Radiotherapy for Targeting Abdominal Cancer

• Procedure: Intervention: MRI-Linac SABR

Inclusion Criteria:

• Aged 18 years or older
• Patients with diagnosisthe process of identifying a disease based on signs and symptoms, patient history and medical test results of oligometastatic disease from primary colorectalrelating to the colon or rectum in the large bowel/intestine, upper gastrointestinal (e.g. gastric, oesophagus, pancreatic), breast, non-small cell lung, renal cell, or gynaecological malignancy. Oligometastatic disease with controlled primary disease* and maximum total of 5 metastatic lesions in a maximum of 2 different organ systems in any of the following sites:
  1. Liver
  2. Adrenal
  3. Abdomino-pelvic lymph nodea small lump or mass of tissue in your body
  4. Other abdominal site e.g. pancreatic, renal.
  5. Other pelvic site
  6. Bony or lung is allowed only if in conjunction with an abdominal site above
• De novo or metachronous oligometastatic disease where the original tumoura tissue mass that forms from groups of unhealthy cells site has been treated with curative intent.
  • Controlled primary disease in metachronous oligometastastic disease defined as at least 3 months since original tumour treated with curative intent and no progression at primary site
  • Controlled primary disease in de novo oligometastatic disease defined as primary tumour site treated with curative intent and no progression at primary site
• Oligometastatic disease: Histological confirmation of primary malignancy (histological confirmation of metastasiswhen the cancer has spread to other parts of the body, also known as mets is not mandatory but should be performed in any situation where there is any diagnostic uncertainty).
• All oligometastatic sites treatable with SABR.

OR

• Patients with oligo-progressive / oligo-persistent disease in maximum total of 2 oligo-progressive abdominal metastases and in a maximum 2 different organ systems
• Visible imagingtests that create detailed images of areas inside the body defined targets and suitable for treatment with SABR
• Childs Pugh A to B7 (in case of liver treatment)
• ECOG 0 -2
• Patient consented