Oncology · London
SBRT for oligometastasis, private in London.
Ablative-dose stereotactic body radiotherapy for 1 to 5 metastases, delivered in 1 to 5 outpatient visits by a consultant clinical oncologist. LINAC, MR-Linac and CyberKnife options across the London centres that do this every week.
Why patients choose us
- 01
A named SBRT centre with a high case volume
Not a general radiotherapy list. A consultant clinical oncologist and a physics team who deliver ablative-dose SBRT to lung, liver, bone, adrenal and nodal sites every week.
- 02
The right technology for the site
Lung and liver on 4D-CT and breath-hold. Moving abdominal targets on the MR-Linac. Spine on CyberKnife or high-precision LINAC. We match kit to lesion.
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Independent, and free
We are paid by no centre, so the recommendation is impartial and costs you nothing.
Indicative pricing
What a private SBRT course costs in London.
All-inclusive ranges across our partner centres: consultation, CT planning, immobilisation, delivery and post-treatment review. Send the imaging and we quote firm figures across two or three centres.
In short
A single-site SBRT course in our London network: £8,500 to £18,000, delivered in 1 to 5 outpatient visits.
| Site and dose | Indicative range | Typical course | Turnaround |
|---|---|---|---|
| Lung SBRT (45 to 54 Gy in 3 to 5 fractions) | £10,500–£16,000 | 1–2 weeks | Same course |
| Liver SBRT (45 to 60 Gy in 3 to 5 fractions) | £12,000–£18,000 | 1–2 weeks | Same course |
| Spine or bone SBRT (24 Gy single or 27 Gy in 3) | £8,500–£14,000 | 1–5 days | Same course |
| Adrenal SBRT (30 to 40 Gy in 3 to 5 fractions) | £11,000–£16,500 | 1–2 weeks | Same course |
| Lymph node SBRT (30 to 45 Gy in 3 to 5 fractions) | £9,500–£15,000 | 1–2 weeks | Same course |
| Second-opinion MDT review of imaging and reports | £350–£650 | 30–45 min | 3–5 days |
Prices vary by centre, by platform (LINAC, MR-Linac or CyberKnife), by number of fractions, and by lesion size and proximity to organs at risk. We come back with a firm quote within two working days.
What oligometastasis is
Limited metastatic disease is a distinct clinical state.
Not every metastatic cancer is the same. A patient with 1 to 5 deposits is biologically different from one with widespread disease, and it opens the door to local ablative treatment with the intent of cure or long control.
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Typically 1 to 5 lesions
The SABR-COMET evidence base was built on patients with 1 to 5 metastases and a controlled primary. SABR-COMET-10 is testing the ceiling at 4 to 10 sites.
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A biologically distinct state
Oligomets sit between localised disease and widespread metastatic disease. In many patients they represent slower, less aggressive tumour biology.
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Potential for cure or long control
Ablating every visible site with SBRT can produce durable remission in colorectal, sarcoma, prostate and breast oligomets, with 5-year survival now measured rather than assumed.
What SBRT is
Ablative radiotherapy, precisely delivered.
Stereotactic body radiotherapy delivers very high doses per fraction, in 1 to 5 visits, using image guidance accurate to a millimetre or better. The intent is ablative, not palliative.
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8 to 20 Gy per fraction
Ten times the dose of a conventional radiotherapy fraction, in a fraction of the visits. That biology is what makes SBRT ablative rather than palliative.
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Submillimetre image guidance
Cone-beam CT before every fraction, MRI on the MR-Linac, or fiducial tracking on CyberKnife. The target is verified in the room, not just in the plan.
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1 to 5 outpatient visits
No admission, no anaesthetic, no needles. Most people drive themselves in, spend 30 to 60 minutes at the centre, and drive back out.
The evidence
SABR-COMET and the trials that followed.
SBRT for oligomets moved from theory to standard of care in the second half of the 2010s, and the phase III evidence base is still expanding.
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SABR-COMET, Lancet 2019
A phase II RCT led by Palma showed a median overall survival of 41 months in the SBRT arm versus 28 months in the standard-care arm, in patients with 1 to 5 metastases and a controlled primary.
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SABR-COMET-10
A phase III trial testing SBRT for 4 to 10 metastases, still recruiting, with overall survival as the primary endpoint. Results expected later in the decade.
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NRG BR-002 and disease-specific data
NRG BR-002 in oligometastatic breast cancer, plus dedicated series in colorectal, prostate (STOMP, ORIOLE) and sarcoma have consolidated the case for SBRT in low-volume disease.
The journey
From referral to response scan, what happens, in order.
One team from first message to first response scan, working alongside your existing oncologist.
Phase 1 · Before treatment
Concierge, off-stage for you
Phase 2 · Treatment week
1 to 5 outpatient fractions
Phase 3 · After
Follow-up and response
- 01
Before
You send us the imaging and history
A short, confidential form. Recent CT or PET-CT, primary histology, systemic treatment to date, and how many mets across which organs.
- 02
Before
MDT review and a recommendation
Within one to two working days: whether SBRT fits the SABR-COMET criteria, or whether surgery, RFA or Y-90 is a better call. Indicative cost across two centres.
- 03
Before
CT planning and immobilisation
A dedicated planning CT with 4D acquisition for lung and liver targets, custom vac-bag or thermoplastic mask, and fiducial markers if needed for tracking.
- 04
Treatment
First fraction at the centre
Cone-beam CT or MR image guidance, position match to submillimetre, then delivery in 15 to 45 minutes. You are awake, still and breathing normally.
- 05
Treatment
Fractions 2 to 5
Repeat on alternate days or daily depending on protocol. Most people drive themselves in and back out. Bone SBRT is often a single fraction.
- 06
After
Early review at 4 to 6 weeks
A clinical review to check acute side effects have settled. Steroids and analgesia adjusted if needed.
- 07
After
Response imaging at 3 months
CT or PET-CT to document local control. Ongoing systemic therapy and surveillance continue with your oncologist.
Typical end-to-end: 2 to 3 weeks from enquiry to first fraction. Course: 1 to 5 fractions. First response scan: 3 months.
Sites treated
Where SBRT works, and where it does not.
The organs and cancers we treat most, with the dose ranges we use. Brain oligomets go to SRS (Gamma Knife or CyberKnife), not SBRT, and we refer accordingly.
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Lung oligomets (colorectal, sarcoma, RCC)
One to five peripheral or central pulmonary lesions under 5 cm. 45 to 54 Gy in 3 to 5 fractions with 4D-CT motion management.
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Liver oligomets (colorectal, breast)
One to three liver deposits under 6 cm, away from luminal bowel. 45 to 60 Gy in 3 to 5 fractions, often on the MR-Linac for on-table adaptation.
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Spine and bone oligomets
Painful or structurally intact vertebral or non-vertebral bone deposits. 24 Gy single fraction or 27 to 30 Gy in 3, ablative rather than palliative dosing.
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Adrenal oligomets
Solitary adrenal deposits from lung, RCC or melanoma primaries. 30 to 40 Gy in 3 to 5 fractions with breath-hold or tracking.
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Isolated nodal recurrence
A single para-aortic, mediastinal or pelvic node on PET-PSMA or FDG-PET. 30 to 45 Gy in 3 to 5 fractions.
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Prostate oligomets (bone or node)
PSMA-PET detected low-volume recurrence. SBRT can defer androgen deprivation by 12 to 24 months in selected men.
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Brain oligomets
Not SBRT territory. Stereotactic radiosurgery (Gamma Knife or CyberKnife) is used for intracranial disease and we refer accordingly.
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Not suitable: widespread progression
More than 5 to 10 active sites, rapid progression on scans, or ECOG 3 to 4 performance status. SBRT is for controlled, low-volume disease.
Cancers that benefit most
The primaries where the evidence is strongest.
The primary tumour type matters. SBRT is best-evidenced in slow-progressing, low-volume disease and, increasingly, alongside modern systemic therapy.
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Colorectal
Lung and liver oligomets from colorectal primaries have some of the longest local-control and OS data. SBRT is offered alongside or after chemotherapy, and can defer or replace surgery.
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Sarcoma
Pulmonary oligomets from soft-tissue and bone sarcoma respond well to SBRT and were well represented in SABR-COMET.
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Prostate
PSMA-PET now finds low-volume nodal and bone oligomets earlier. STOMP and ORIOLE showed SBRT delays androgen deprivation by a median of 12 to 24 months.
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Breast
Oligometastatic breast cancer, especially oligoprogression on endocrine therapy, is a growing SBRT indication. NRG BR-002 has recently reported.
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Renal cell
RCC oligomets in bone, lung and adrenal respond to SBRT, and sequencing with tyrosine kinase inhibitors or immunotherapy is now standard.
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Melanoma and NSCLC
SBRT plus immunotherapy has shown promising synergy in melanoma and non-small cell lung oligomets, and is often used in oligoprogression on a working systemic agent.
Platforms and techniques
SBRT is a family of platforms, matched to the target.
What each option on the table actually involves, and which lesion each is best for. We choose the platform to fit the target, not the other way around.
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LINAC-based SBRT (VMAT)
The workhorse. Volumetric modulated arc therapy on a modern linear accelerator with cone-beam CT guidance. Suitable for most lung, liver, bone and nodal targets.
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MR-Linac adaptive SBRT
Live MRI at every fraction lets the plan be re-optimised on the day for organ motion and filling. First choice for liver, pancreas and adrenal near bowel.
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CyberKnife robotic SBRT
A robotic arm tracks fiducial markers in real time. Preferred for spine, prostate and small peripheral lung targets where submillimetre tracking matters.
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Proton beam SBRT
A Bragg peak drops dose beyond the target. Considered for re-irradiation, paediatric cases, or lesions abutting spinal cord or bowel where sparing is critical.
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4D-CT and breath-hold
Lung and liver targets move with respiration. A 4D planning CT, deep inspiration breath-hold or abdominal compression keeps the tumour in the beam.
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Single-fraction SBRT (SRS-style)
Increasingly used for bone (24 Gy x 1) and small peripheral lung lesions. One visit, ablative dose, evidence base growing.
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SBRT plus systemic therapy
Sequencing with immunotherapy, chemotherapy or hormone therapy is now standard for many oligomet settings. Timing is planned across your oncology team.
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Second-opinion MDT review
A specialist review of your imaging, PET-CT and prior treatment to decide whether SBRT, surgery, RFA or Y-90 is the best local ablative option.
Our vetted London network
A small panel of London SBRT centres, we picked them.
Consultant clinical oncologists with high SBRT case volumes, in centres accredited under the SABR-UK Consortium. Includes The Royal Marsden Private, GenesisCare (Cromwell and 152 Harley Street), HCA London Bridge and The Harley Street Clinic, UCLH Private, and the MR-Linac programme at Guy's/The Royal Marsden. The Christie Private Care in Manchester takes selected London referrals.
Selection criteria
How we choose every centre in our network.
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Consultant clinical oncologists sub-specialised in SBRT with high annual case volumes
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Centres with 4D-CT, cone-beam CT and either MR-Linac, CyberKnife or high-precision VMAT LINACs
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MDT pathways to thoracic surgery, hepatobiliary surgery, interventional radiology and Y-90
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On-site medical physics with SABR-UK Consortium quality assurance standards
Safety and recovery
What to expect during and after, honestly.
SBRT is a well-tolerated outpatient treatment. The things worth planning are your fatigue window, site-specific effects, and how the course fits around your systemic therapy.
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Fatigue in the second week
The commonest side effect. Usually mild, peaks around week 2 to 3, settles within a month. Most people continue working.
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Lung SBRT: pneumonitis and rib pain
Radiation pneumonitis in around 5 to 10% at 3 to 6 months, usually mild. Chest wall pain and small risk of rib fracture with peripheral lesions.
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Liver SBRT: transient LFT rise
A short, self-limiting rise in liver enzymes at 4 to 8 weeks. Classic radiation-induced liver disease is rare with modern SBRT planning.
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Spine SBRT: pain flare and VCF risk
Steroid cover for 5 days reduces pain flare. Vertebral compression fracture risk around 5 to 15%, higher with lytic lesions and single-fraction dosing.
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Adrenal SBRT: adrenal insufficiency
Uncommon after unilateral treatment. If the contralateral gland is compromised, endocrine review before and after treatment is essential.
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GI toxicity near bowel
Lesions within 1 cm of stomach, duodenum or small bowel need careful planning or MR-Linac adaptation to avoid ulcer or perforation.
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Repeat SBRT is possible
Second and third SBRT courses can be delivered to new sites when the total dose to normal tissue allows. Re-irradiation of the same site needs proton or MR-Linac planning.
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Return to work and driving
Most people drive themselves to fractions and return to work the next day. Bone SBRT patients may need 48 hours of extra analgesia.
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Red flags after treatment
New breathlessness, worsening cough, severe abdominal pain, new neurological signs after spine SBRT, or persistent fevers. Contact the centre the same day.
Reading your SBRT summary
Your treatment summary in four parts. Read the last one first.
Whichever platform delivered the course, the end-of-treatment letter you receive keeps to the same shape.
A quiet reminder
Radiotherapy language is precise and can read coldly, we translate it for you.
If you would like us to talk you through the summary before your review, just ask.
- 01 Header
Site, size and prescription dose
The organ and lesion treated, the gross tumour volume in cc, the planning target volume, and the prescription in Gy per fraction.
- 02 Technique
Platform, guidance and motion management
Which machine (LINAC, MR-Linac, CyberKnife), whether cone-beam CT or MRI guidance was used, and how respiratory motion was managed.
- 03 Findings
Dose to organs at risk
Actual dose delivered to spinal cord, lung V20, liver mean, stomach and bowel Dmax. Read this to understand your future re-treatment options.
- 04 Impression
Follow-up and response imaging plan
Read this first: when your first response scan is booked, what steroids or analgesia you go home on, and what to do about your systemic therapy.
Recognised by major UK insurers
Cover for SBRT is standard when MDT-recommended for oligometastatic disease. We confirm cover with your insurer before booking.
Frequently asked
Everything we get asked about SBRT for oligomets.
Quick answers on pain, side effects, repeat courses, number of mets, insurance and outcomes.
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Does SBRT hurt during treatment?
No. SBRT itself is completely painless. You lie still on the treatment couch for 15 to 45 minutes per fraction while the machine rotates around you. There is no needle, no anaesthetic and no incision. Spine SBRT patients sometimes get a short pain flare in the first few days after treatment, which is why we cover you with a 5-day course of dexamethasone.
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What are the side effects?
Most people get moderate fatigue in the second week that settles within a month. Site-specific effects are usually mild: a small pneumonitis risk after lung SBRT, a transient rise in liver enzymes after liver SBRT, a pain flare and around 5 to 15% risk of vertebral compression fracture after spine SBRT. Serious complications are uncommon in a well-planned course.
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Can I have SBRT more than once?
Yes. Second and third courses to new sites are common in oligometastatic disease and are limited only by the cumulative dose to normal tissue in the area. Re-irradiation of a previously treated site is harder and usually needs proton beam or MR-Linac planning to keep organs at risk within safe limits.
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Is there a limit on how many mets can be treated?
The SABR-COMET trial that established the evidence base used 1 to 5 metastases. SABR-COMET-10, still recruiting, is testing SBRT for 4 to 10 sites. In practice most UK centres will consider SBRT for up to 5 sites in one course, with the option of a further course later if new lesions appear.
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Will my insurance pay for SBRT?
Yes, in most cases. Bupa, AXA, Vitality, Aviva, WPA and Cigna all fund SBRT for oligometastatic disease when it is recommended by an MDT. Pre-authorisation is straightforward when the referral letter cites the SABR-COMET evidence and confirms low-volume, controlled disease. We handle the paperwork.
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What are the outcomes?
The SABR-COMET phase II RCT (Palma et al, Lancet 2019) showed a median overall survival of 41 months with SBRT plus standard care versus 28 months with standard care alone in patients with 1 to 5 mets. Local control at the treated site is 80 to 95% at 2 years for most sites. Outcomes are best in colorectal, sarcoma, prostate and breast primaries.
Related treatments
Looking for something else?
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Proton beam therapy
Bragg-peak radiotherapy for re-irradiation and paediatric cases.
Learn more -
MR-Linac adaptive radiotherapy
Live-MRI adaptive planning for moving abdominal targets.
Learn more -
Y-90 radioembolisation
Selective internal radiation for liver oligomets.
Learn more -
Gamma Knife radiosurgery
Frame-based single-fraction radiosurgery for brain mets.
Learn more -
CyberKnife
Robotic tracked radiosurgery for spine and prostate.
Learn more -
Prostate cancer
Diagnosis, staging and treatment pathways.
Learn more -
Colorectal cancer
Diagnosis, staging and treatment pathways.
Learn more -
Send Enquiry
Tell us the case and we come back within two working days.
Learn more
Send the imaging
An MDT read and two London SBRT options, within two working days.
Free, confidential, no obligation. Send us the recent CT or PET-CT, the primary histology and a note of any current systemic therapy, and we come back with a plan.