Oligoprogressive liver metastasis from gastrointestinal stromal tumour treated with stereotactic body radiotherapy (SBRT)

While metastatic gastrointestinal stromal tumours (GIST) are generally treated using systemic therapy, surgery and/or ablative procedures, radiotherapy appears to have a restricted role. We present a case of a woman in her 40s with metastatic GIST treated over 10 years with two lines of tyrosine kinase inhibitors (TKIs). During sunitinib therapy, a solitary oligoprogressive lesion was found. Since she was unable to afford a subsequent line of TKI, the lesion was assessed for local ablative options. It was deemed suitable for stereotactic body radiotherapy (SBRT) at a dose of 42 Gy in 6 Fractions. She tolerated the treatment well and continued sunitinib. At the 2-year follow-up, the liver lesion showed partial response, with the patient having no late post-SBRT sequelae and continuing the same TKI. SBRT seems to be a safe and effective local ablative option for the treatment of oligoprogressive lesions in GIST.