Escape velocity.

How should we manage progression after ablative local therapy for oligometastatic cancer? This study applied the concept of brain metastasis velocity to calculate distant metastasis velocity (DMV) in over 300 patients who progressed following SBRT for 5 or fewer oligometastases. The median DMV was 0.7 mets/month, and they classified <0.5 mets/month, 0.5-1.5 mets/month, and >1.5 mets/month as low, intermediate, and high DMV. Lower DMV was associated with better overall survival and a lower risk of widespread failure. In other words, when evaluating patients with initial oligometastatic disease for additional focal therapy after SBRT, those with a high DMV >1.5 metastases/month have worse survival and higher risk of widespread failure. | Willmann, Int J Radiat Oncol Biol Phys 2022