Please click on the links below for more information and support materials for patients.

Bladder

Brain

Breast cancer

Gynaecological

Head and neck

Lower gastrointestinal

Lung

Oesophagus

Paediatric

Prostate cancer

Sarcoma 

Thyroid - coming soon

Upper GI - coming soon

This information has been collated and reviewed by a Patient Information Working Group of therapeutic radiographers representing all radiotherapy departments in the region that together form the South West Radiotherapy Operational Delivery Network (SW RT ODN).

To ensure the radiotherapy-specific patient information stays up to date, the resources will be reviewed by the Working Group on a three-year basis or when a major change arises. The Group will also be undertaking periodic audits to monitor the ways the patient information is distributed.

Criteria and Instructions for Referral of Patients with Oligometastatic Disease for SABR at Bristol Cancer Institute

 

Oligometastases (3 sites or less)
Site	Currently available at Bristol	Comments
Lung	Yes
Bone (non spine)	Yes
Spine	Yes
Lymph nodes	Yes
Adrenal	Yes
Liver	Yes
Re-irradiation of pelvis	No	Available at selected centres

 

General criteria

• Metastatic Cancer with either a histologically or cytologically proven primary site (or a male patient with PSA>50 and clinical evidence of prostate cancer)
• 1 - 3 sites of metastatic disease
• Maximum size of any single metastasis of 6cm (5cm for lung or liver)
• Disease free interval  between primary treatment and development of metastases >6 months
• Life expectancy > 6 months
• Performance status 0 - 2
• Exclude patients who have had previous radiotherapy within  the planned treatment volume
• Prior discussion with disease site specific oncologist
• Prostate/Lung/Breast - once CORE trial open these patients will not be eligible for CtE

 

Site Specific criteria

Lung

• Histologically or radiologically confirmed lung metastases
• Not suitable for surgery due to co-morbidities, inadequate lung function or disease status
• Peripherally located lung metastases (>2cm from radius of main airways and proximal bronchial tree)

Lymph nodes

• Exclude patients requiring irradiation of whole nodal field

Adrenal

• Absent or limited and potentially treatable extra-adrenal disease
• Systemic therapy completed (or discontinued 4 weeks before SABR started)

Liver

• 1 - 3 liver metastases on contrast enhanced CT and/or MRI
• Unresectable, patient unfit for surgery or presence of extra-hepatic disease makes surgery inappropriate
• Childs-Pugh Class A
• Adequate hepatic function:
  • >700cc normal liver (liver volume-gross tumour volume)
  • Bilirubin < 3 x upper limit of normal
  • NR < 1.3
  • ALT < 5 x upper limit of normal
  • Platelets > 80
  • Exclude patients with active hepatitis or clinically significant liver failure, clinically apparent ascites or CNS metastases
  • Patient suitability established at Hepatobiliary MDT prior to referral

 

Instructions for referral

Please send your referral letter from a secure nhs.net email account to the following group email account:

ubh-tr.SABRteam@nhs.net

Please also send the results of any relevant tests e.g. lung function, liver function to this address.

Please make available any recent scans for the team in Bristol to view.

If you are referring from another hospital trust please complete an Inter-provider Transfer Form and email to the above address.

Please complete the relevant SABR referral checklist below:

• SABR Oligomets
• SABR Primary lung

Any further queries should be directed via the email account or to:

Dimitra Kalogianni

SABR Co-ordinator

0117 342 3970

Jancis Kinsman

SABR Lead Radiographer

0117 342 4469

Dr Charles Comins

SABR Clinical Lead

0117 342 3176