Journal article
Stereotactic Body Radiation Therapy for Sarcoma Pulmonary Metastases
American journal of clinical oncology, Vol.46(6), pp.263-270
06/01/2023
DOI: 10.1097/COC.0000000000001000
PMID: 36914598
Abstract
Background:Lung metastases are the most common form of distant failure for patients diagnosed with sarcoma with metastasectomy considered for some patients with limited metastatic disease and good performance status. Alternatives to surgery such as stereotactic body radiation therapy (SBRT) can be considered, though data are limited. We present outcomes after SBRT for sarcoma lung metastases. Methods:Fifty sarcoma patients with 109 lung metastases were treated with SBRT between 2005 and 2021. Outcomes evaluated included local control (LC), overall survival (OS), and toxicity including lung pneumonitis/fibrosis, chest wall toxicity, dermatitis, brachial plexus, and esophageal toxicity. Systemic therapy receipt before and after SBRT was recorded. Results:SBRT schedules were divided into 3 cohorts: 30 to 34 Gy/1fx (n=10 [20%]), 48 to 50 Gy/4 to 5fx (n=24[48%]), and 60 Gy/5fx (n=16[32%]). With a median follow-up of 19.5 months, 1/3-year LC rates were 96%/88% and 1/3-year OS 77%/50%, respectively. There was no differences between the 3 regimens in terms of LC, OS, or toxicity. Size >4 cm was a predictor of worse LC (P=0.031) and worse OS (P= 0.039) on univariate analysis. The primary pattern of failure was new metastases (64%) of which the majority were in the contralateral lung (52%). One-year chemotherapy-free survival was 85%. Overall, 76% of patients did not require chemotherapy initiation or change of chemotherapy regimen after lung SBRT. Toxicity was reported in 16% of patients overall, including 25%, 20%, and 14% in the 30 to 34 Gy/1fx, 48 to 50 Gy/4 to 5fx, and 60 Gy/5fx cohorts, respectively. Conclusions:SBRT outcomes for lung metastases from sarcoma demonstrate high rates of LC and are similar with different dose/fractionation regimens. Lung SBRT is associated with prolonged chemotherapy-free survival. Prospective validation of these results is warranted.
Details
- Title: Subtitle
- Stereotactic Body Radiation Therapy for Sarcoma Pulmonary Metastases
- Creators
- Wafa Asha - King Hussein Cancer CenterSami Koro - Radiation Oncology AssociatesZachary Mayo - Radiation Oncology AssociatesKailin Yang - Radiation Oncology AssociatesAhmed Halima - Radiation Oncology AssociatesJacob Scott - Radiation Oncology AssociatesJessica Scarborough - Radiation Oncology AssociatesShauna R. Campbell - Radiation Oncology AssociatesG. Thomas Budd - Cleveland ClinicDale Shepard - Cleveland ClinicKevin Stephans - Radiation Oncology AssociatesGregory M. Videtic - Radiation Oncology AssociatesChirag Shah - Radiation Oncology Associates
- Resource Type
- Journal article
- Publication Details
- American journal of clinical oncology, Vol.46(6), pp.263-270
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1097/COC.0000000000001000
- PMID
- 36914598
- ISSN
- 0277-3732
- eISSN
- 1537-453X
- Number of pages
- 8
- Language
- English
- Date published
- 06/01/2023
- Academic Unit
- Radiation Oncology
- Record Identifier
- 9984696720402771
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