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Purpose: With a constantly increasing life expectancy, the issue of treating oncological older patients rises, representing a therapeutical challenge for the scientific community. Several literature studies support SBRT in the treatment of the oligometastatic patient as a potentially curable therapeutic option. However, data on older patients are sparse. 

Methods: From December 2013 to October 2020 a cohort of 61 oligometastatic patients over the age of 80 years received SBRT, which was proposed for subjects with a minimum Karnofsky Performance Status ≥ 70, a life expectancy of at least 6 months, and up to five oligometastatic lesions. Radiotherapy was delivered in 3-10 fractions with VMAT-IGRT technique. Toxicity was retrospectively collected according to CTCAE v4.0. Univariate and multivariate analysis were performed for assessing any potential predictive factor for clinical outcomes. 

Results: A total of 90 oligometastases were treated in 61 patients with median age 82 years (range, 80-90). The most frequent histology was colorectal cancer (27% of cases). With a median follow-up of 20 months (2-63), our Local control rates at 1- and 2-years were 98.8% and 88.2%. Colorectal histology was found to be associated with worse LC rates (p = 0.014) at univariate analysis. Progression-free survival rates at 1- and 2-years were 48.6% and 30.5%. At univariate analysis, oligorecurrent lesions and single oligometastases were associated with better PFS rates (respectively, p = 0.04 and p = 0.011). 1- and 2-years overall survival rates were 75% and 60.5%, with polymetastatic spread being predictive of lower survival outcomes at multivariate analysis (p = 0.012). All treatments were well tolerated with no interruptions and no G2 or higher adverse events recorded. 

Conclusions: Our study supports the role of SBRT for elderly oligometastatic patients, highlighting the potential of this therapeutic option in the management of older oncological patients.