MRL-SABR for oligometastatic disease

MRL-SABR (magnetic resonance linac combined with stereotactic ablative radiotherapy) represents a paradigm shift in the management of oligometastatic disease, offering a targeted and minimally invasive treatment option with the potential for improved outcomes.

Here, Dr Sathish Harinarayanan, renowned consultant clinical oncologist, provides an expert insight into the intricacies of MRL-SABR and its role in the treatment of oligometastatic disease.

What is MRL-SABR and what is oligometastatic disease?

MRL-SABR, an acronym for magnetic resonance linac combined with stereotactic ablative radiotherapy, is a sophisticated treatment for oligometastatic disease. Oligometastatic disease refers to a state where cancer has spread from its primary site to a limited number of distant locations, typically involving five or fewer metastatic lesions.

MRL-SABR integrates the precision of advanced imaging technology, using the magnetic resonance Linac machine to treat cancer, with targeted radiotherapy to combat the cancer metastases in oligometastatic disease. Treatment planning for MRL-SABR involves a multidisciplinary team of specialists, including clinical oncologists, to ensure optimal outcomes.

How does MRL-SABR differ from other treatments for oligometastatic disease?

Traditional treatments for oligometastatic disease often include systematic chemotherapy, surgical intervention, or palliative measures aimed at symptom management. While these approaches can be effective, they may carry risks and limitations. MRL-SABR combines advanced imaging techniques to precisely identify metastatic lesions and deliver high doses of radiation to specific areas while minimising damage to surrounding healthy tissue.

What are the benefits of MRL-SABR?

MRL-SABR offers several benefits. Firstly, it offers enhanced tumour control, due to its ability to deliver high doses of radiation directly to metastatic sites. Additionally, MRL-SABR typically entails shorter treatment durations and reduced risk of treatment-related side effects. Moreover, by selectively targeting oligometastases, MRL-SABR may also improve overall survival and patient quality of life.

What is the process of MRL-SABR, from diagnosis to treatment? Are there any other specific imaging or diagnostic tests required?

The procedure for MRL-SABR typically involves two main steps:

1. The patient undergoes scanning with the magnetic resonance imaging radiotherapy machine to precisely map out and pinpoint the location and extent of metastatic lesions. 

2. Once the metastases are identified, the patient undergoes stereotactic ablative radiotherapy, where highly focused radiation beams are precisely directed at the target lesions by tracking the tumour during treatment, also allowing for on-table adaptation of the radiotherapy plan. This targeted approach minimises damage to surrounding healthy tissue while maximising the therapeutic effect on the cancerous cells.

Is MRL-SABR safe?

Studies provide evidence that MR-Linac guided adaptive SABR is a safe and viable option for treatment compared to conventional CT-SABR treatments, with excellent results. The average treatment time on MR-Linac machines may be a bit longer than on standard CT linac, however, the use of ultra-hypofractionated SABR allows delivery of the total dose in fewer fractions.

What are the expected outcomes or success rates of MRL-SABR for oligometastatic disease?

Success rates of MRL-SABR for oligometastatic disease can vary depending on various factors, including the type and stage of cancer, the number and location of metastatic lesions, and individual patient characteristics. However, real-life cases and clinical studies have shown promising results with MRL-SABR, including high rates of local tumour control and potential improvements in overall survival and patient quality of life.

If you would like to know more about MRL-SABR for oligometastatic disease, schedule an appointment with Dr Sathish Harinarayanan via his Top Doctors profile today.