Lung Cancer Radiotherapy Using Realtime Dynamic Multileaf Collimator (MLC) Adaptation And Radiofrequency Tracking

Inclusion Criteria: * Aged 18 or older * Has provided written Informed Consent for participation in this trial and is willing to comply with the study * Patients undergoing external beam radiotherapy at Northern Sydney Cancer Centre * Histologically proven Stage I Non Small Cell Lung Cancer (NSCLC) oligometastatic lung metastases (3 or less). Histological diagnosis will be obtained if clinically indicated. * MRI/4D-CT prior to insertion of Calypso beacons * Patient must be able to have Varian Calypso beacons placed in the lung (if on anticoagulants, must be cleared by Local Medical Officer (LMO) or cardiologist). * Eastern Cooperative Oncology Group (ECOG) performance status 0-2 * Body habitus enabling Calypso tracking (as per Calypso Determining a Patient's Localisation Designation \& Orientation before implantation) * A maximum of three metastases to the lung from any non-haematological malignancy. Multiple metastases will be treated separately. * Tumour diameter ≤ = 5cm Exclusion Criteria: * Previous high-dose thoracic radiotherapy. * Less than two Calypso beacons implanted in the lung. * Calypso beacons are spaced by greater than 9cm or less than 1cm. * Calypso beacons are less than 19cm from outer chest wall * Cytotoxic chemotherapy within 3 weeks of commencement of treatment, or concurrently with treatment. Hormonal manipulation agents are allowable (e.g. aromatase inhibitors, selective oestrogen receptor modulators, and gonadotropin releasing hormone receptor modulators) * Targeted agents (such as sunitinib, bevacizumab and tarceva) within 7 days of commencement of treatment, or concurrently with treatment * Women who are pregnant or lactating. * Unwilling or unable to give informed consent * Unwilling or unable to complete quality of life questionnaires