Skip to content
left end
left end
right end

Referrals

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:

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