Patients with head and neck squamous cell carcinoma (HNSCC) who develop post-treatment distant metastases (DM) have a poor prognosis and few treatment options. DMs from HNSCC are rare compared to other solid tumors, occurring in 5%–20% of patients [Citation1,Citation2]. Some patients with DM may have limited metastases in few metastatic sites. This has been coined the ‘oligometastatic state’ and is most often defined as up to five DMs [Citation3–6]. In HNSCC, 30%–40% of patients with DM have oligometastases at DM diagnosis [Citation3]. Oligometastases may be eligible for surgery, radiotherapy or other local ablative therapies (LAT), and the patients may benefit from an aggressive local strategy with prolonged disease-free survival, deferral of systemic treatment, and sometimes even cure [Citation7–9]. LAT has shown promising results, especially for stereotactic body radiation therapy (SBRT) [Citation8,Citation10]. Prospective SBRT studies in the palliative setting include only a few HNSCC patients [Citation11,Citation12].

Historically, fit patients with oligometastatic HNSCC were offered metastasectomy (most often lung resections) and SBRT was infrequently used. Technical advances in radiotherapy have facilitated improved precision and sparing of normal tissue, making SBRT a favorable option. The proportion of patients with oligometastatic HNSCC was assessed in a complete cohort including the potential for SBRT treatment.