Single vs. Multiple Fraction Trial of Stereotactic Ablative Radiotherapy for Comprehensive Treatment of Oligometastases/Progression

"Participants randomized to this arm will receive SF SABR~Treatment recommendations are as follows:~Lung: Greater than 2 cm from mediastinum or brachial plexus or if mandatory OAR constraints are met: 30 Gy in 1 fraction~Lung: Within 2 cm of mediastinum or brachial plexus 20 Gy in 1 fraction~Bone, Spine, Adrenal, lymph node/soft tissue: 20 Gy in 1 fraction~Liver: 30 Gy in 1 fraction~Brain: dose as per institutional policy"

"Participants randomized to this arm will receive MF SABR:~Dose/Fractionation are as follows:~Lung: Greater than 2 cm from mediastinum or brachial plexus or if mandatory organ-at-risk (OAR) constraints are met: 48 Gy in 4 fractions (12 Gy/#), 54 Gy in 3 fractions (18 Gy/#), daily or every second day~Lung: Within 2 cm of mediastinum or brachial plexus 60 Gy in 8 fractions (7.5 Gy/#), 50 Gy in 5 fractions (10 Gy/#), daily~Bone: Any bone except spine: 35 Gy in 5 fractions (7 Gy/#), daily~Liver: 54 Gy in 3 fractions (18 Gy/#) or 5 fractions (10.8 Gy/#), daily or every second day~Spine: 24 Gy in 2 fractions (12 Gy/#) or 35 Gy in 5 fractions (7 Gy/#), daily~Adrenal: 40 Gy in 5 fractions (8 Gy/#) or 35 Gy in 5 fractions (7 Gy/#), daily~Lymph node/soft tissue: 40 Gy in 5 fractions (8 Gy/#) or 35 Gy in 5 fractions (7 Gy/#), daily~Brain - dose per institutional policy for stereotactic lesions (no whole brain RT)."

Participants randomized to this arm will complete the EQ-5D-5L and FACT-G at baseline and each follow-up visit

Participants randomized to this arm will complete the FACT,G, EQ-5D-5L, radiation-symptom screen and receive healthcare provider-guided intervention based on their symptom reports.