Stereotactic body radiotherapy for oligometastatic soft tissue sarcoma

Loi, Mauro; Duijm, M.; Baker, Sarah; Rossi, L.; Grünhagen, Dirk J.; Verhoef, Cornelis; Nuyttens, J.

doi:10.1007/s11547-018-0912-5

Cited by 21 publications

(17 citation statements)

References 22 publications

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“…Eighty two percent had received prior chemotherapy and 66% had been treated with metastatectomy. The Rochester, Erasmus, and University of California, Los Angeles (UCLA) series also reported no grade 3 adverse events 17,25,26 . Rates of grade 2 pneumonitis were low in our series and these others, in which relatively few patients received multiple courses of lung SBRT, even though our series and the UCLA series had many patients previously treated with metastatectomy.…”

Section: Discussionmentioning

confidence: 44%

“…The University of Rochester study of 15 patients treated with lung SBRT to a median dose of 50 Gy in five fractions reported 3‐year local control of 82% and median overall survival of 2.1 years 17 . The series by Loi et al 25 from the Erasmus MC Cancer Institute in the Netherlands reported on 16 patients with 21 lung metastases and five lymph node or soft tissue metastases treated with SBRT from 2005 to 2016. At 4 years, the local control was 78%, OS was 54%, and median OS was 69 months (95% CI, 20‐118 months] 25 .…”

Section: Discussionmentioning

confidence: 99%

“…The series by Loi et al 25 from the Erasmus MC Cancer Institute in the Netherlands reported on 16 patients with 21 lung metastases and five lymph node or soft tissue metastases treated with SBRT from 2005 to 2016. At 4 years, the local control was 78%, OS was 54%, and median OS was 69 months (95% CI, 20‐118 months] 25 . In the UCLA series, there were 16 patients with sarcoma pulmonary metastases treated with SBRT from 2009 to 2011 26 .…”

Section: Discussionmentioning

confidence: 99%

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Multi‐institutional analysis of stereotactic body radiotherapy for sarcoma pulmonary metastases: High rates of local control with favorable toxicity

Baumann

Bernstein

DeLaney

et al. 2020

Journal of Surgical Oncology

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Background/Objectives Oligometastatic sarcoma pulmonary metastases (PM's) are traditionally treated with resection and/or chemotherapy. We hypothesize that stereotactic body radiotherapy (SBRT) is an effective, safe alternative to surgery that can achieve excellent local control (LC) with a favorable toxicity profile. Methods Patients treated with SBRT for sarcoma PM's from 2011 to 2016 at Massachusetts General Hospital and the University of Pennsylvania were included. Median dose was 50 Gy. Patients underwent computed tomography (CT) or positron emission tomography/CT Q3 months post‐SBRT. Results 44 patients with 56 separate PM's were treated with SBRT. Median age was 59 (range 19‐82). 82% received prior chemotherapy, 66% had prior pulmonary resections (range, 1‐5 resections), and 32% received prior thoracic radiotherapy. Median lesion size was 2.0 cm (range, 0.5‐8.1 cm). Median follow‐up was 16 months and 25 months for patients alive at last follow‐up. Overall survival at 12 and 24 months was 74% (95% confidence interval [CI], 67%‐81%) and 46% (95% CI, 38%‐55%). LC at 12 and 24 months was 96% (95% CI, 93%‐98%) and 90% (95% CI, 84%‐96%). LC and overall survival did not differ based on age, gender, histology, fractionation, lesion location, or size (P > .05). Three developed Common Terminology Criteria for Adverse Events version 4 grade‐2 chest‐wall toxicities; one had grade‐2 pneumonitis. Conclusions In the first multi‐institutional series on SBRT for sarcoma PM's, SBRT has excellent LC and is well‐tolerated. SBRT should be considered as an alternative/complement to resection.

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Section: Discussionmentioning

confidence: 44%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Multi‐institutional analysis of stereotactic body radiotherapy for sarcoma pulmonary metastases: High rates of local control with favorable toxicity

Baumann

Bernstein

DeLaney

et al. 2020

Journal of Surgical Oncology

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“…Current studies on the role of SBRT in soft tissue sarcoma including primary and metastatic lesions are shown in the table7 [12][13] . Based on their experience.…”

Section: Discussionmentioning

confidence: 99%

Stereotactic Body Radiotherapy for Metastatic and Recurrent Soft Tissue Sarcoma

Feng¹,

Li²,

Li³

et al. 2020

Preprint

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BackgroundSoft tissue sarcoma（STS） is a malignant tumor of highly heterogeneous mesenchymal origin. STS has a biologic pattern and clinical transformation with localized invasive growth and susceptibility to hematogenous metastasis. Metastatic and recurrent soft tissue sarcoma may be treated by local therapeutic options, including surgery and radiation therapy. This study evaluated the safety and efficacy of SBRT for metastatic and recurrent soft tissue sarcoma.MethodsWe performed a retrospective analysis of 37 STS patients with 58 lesions treated with SBRT from 2009-2019 at our institution. We analyze the local control (LC), overall survival (OS), progression free survival (PFS) and toxicity rates of the patients.ResultThe median follow-up was 20 months（range 2 to 120 months）. One and two year LC rates were 75.3% and 55.2% [95% confidence interval (CI) 20–25 months]. Median OS was 24 months and the survival rates were 66.6%, 45% and 26.6% at 1, 2 and 3-year after SBRT. Median PFS were 11months (95% CI 8–18 months). No acute or chronic grade ≥ 3 toxicity was observed.ConclusionsIn patients with metastatic and recurrent STS, LC, OS and PFS were higher than expected. SBRT should be a proper treatment option for STS.

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“…Stereotactic body radiotherapy (SBRT) and stereotactic radiosurgery (SRS) can be used in selected patients who are poor candidates for surgery. SBRT attains excellent tumor control with limited toxicity in patients with lung metastases (III, B) [11]. In subsequent relapses, repeated SBRT may also be considered.…”

Section: Surgery and Radiotherapymentioning

confidence: 99%

SEOM Clinical Guideline of management of soft-tissue sarcoma (2020)

et al. 2021

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Soft-tissue sarcomas constitute an uncommon and heterogeneous group of tumors of mesenchymal origin. Diagnosis, treatment, and management should be performed by an expert multidisciplinary team. MRI/CT of the primary tumor and biopsy is mandatory before any treatment. Wide surgical resection with tumor-free tissue margin is the mainstay for localized disease. Radiotherapy is indicated in large, deep, high-grade tumors, or after marginal resection not suitable for re-excision. Perioperative chemotherapy should be discussed for high-risk sarcomas of the extremities and trunk-wall. In the case of oligometastatic disease, patients should be considered for local therapies. First-line treatment with anthracyclines (or in combination with ifosfamide) is the treatment of choice. Other drugs have shown activity in second-line therapy and in specific histological subtypes but options are limited and thus, a clinical trial should always be discussed.

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Stereotactic body radiotherapy for oligometastatic soft tissue sarcoma

Cited by 21 publications

References 22 publications

Multi‐institutional analysis of stereotactic body radiotherapy for sarcoma pulmonary metastases: High rates of local control with favorable toxicity

Multi‐institutional analysis of stereotactic body radiotherapy for sarcoma pulmonary metastases: High rates of local control with favorable toxicity

Stereotactic Body Radiotherapy for Metastatic and Recurrent Soft Tissue Sarcoma

SEOM Clinical Guideline of management of soft-tissue sarcoma (2020)

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