Abstract
Background The most common site of sarcoma metastasis is the lung. Surgical resection of pulmonary metastases and chemotherapy are treatment options that have been employed, but many patients are poor candidates for these treatments for multiple host or tumor-related reasons. In this group of patients, radiation might provide a less morbid treatment alternative. We sought to evaluate the efficacy of radiotherapy in the treatment of metastatic sarcoma to the lung. Methods Stereotactic body radiotherapy (SBRT) was used to treat 117 pulmonary metastases in 44 patients. Patients were followed with serial computed tomography imaging of the chest. The primary endpoint was failure of control of a pulmonary lesion as measured by continued growth. Radiation-associated complications were recorded. Results The majority of patients (84%) received a total dose of 50 Gy per metastatic nodule utilizing an image-guided SBRT technique. The median interval follow-up was 14.2 months (range 1.6–98.6 months). Overall survival was 82% at two years and 50% at five years. Of 117 metastatic nodules treated, six nodules showed failure of treatment (95% control rate). Twenty patients (27%) developed new metastatic lesions and underwent further SBRT. The side effects of SBRT included transient radiation pneumonitis (n=6), cough (n=2), rib fracture (n=1), chronic pain (n=1), dermatitis (n=1), and dyspnea (n=1). Conclusion Stereotactic body radiotherapy is an effective and safe treatment for the ablation of pulmonary metastasis from sarcoma. Further work is needed to evaluate the optimal role of SBRT relative to surgery or chemotherapy for treatment of metastatic sarcoma.
Highlights
Soft tissue and bone sarcomas represent less than 1% of all malignancies diagnosed in the United States annually [1].e most common site of metastasis is the lung, with pulmonary metastatic disease occurring in 19–50% of patients [2,3,4]
Metastasectomy and/or chemotherapy are the most common treatments offered to patients with metastatic sarcoma
External beam radiotherapy (EBRT) has been shown to decrease local recurrence when used in conjunction with surgery for primary localized soft tissue sarcoma [11, 12]
Summary
Soft tissue and bone sarcomas represent less than 1% of all malignancies diagnosed in the United States annually [1].e most common site of metastasis is the lung, with pulmonary metastatic disease occurring in 19–50% of patients [2,3,4]. Metastasectomy and/or chemotherapy are the most common treatments offered to patients with metastatic sarcoma. Either video assisted or through formal thoracotomy, has been shown to increase overall survival in select populations of both osseous and soft tissue sarcoma patients [2, 3, 5,6,7]. While chemotherapy remains an important tool for treatment of patients with metastatic sarcoma, there is mixed evidence on its survival impact [8,9,10]. External beam radiotherapy (EBRT) has been shown to decrease local recurrence when used in conjunction with surgery for primary localized soft tissue sarcoma [11, 12]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
