Mauro Loi1, Marloes Duijm2, Sarah Baker2, Linda Rossi2, Dirk Grunhagen3, Cornelis Verhoef3, Joost Nuyttens2. 1. Department of Radiation Oncology, Erasmus MC Cancer Institute, PO Box 2040, 3000 CA, Rotterdam, The Netherlands. m.loi@erasmusmc.nl. 2. Department of Radiation Oncology, Erasmus MC Cancer Institute, PO Box 2040, 3000 CA, Rotterdam, The Netherlands. 3. Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
Abstract
BACKGROUND: Stereotactic body radiotherapy (SBRT) is emerging as a novel treatment option in metastatic soft tissue sarcoma (STS). The aim of our study was to evaluate the effectiveness of exclusive SBRT on disease control and survival in oligometastatic (≤ 3 synchronous lesions) STS. MATERIALS AND METHODS: In total, 16 consecutive patients, accounting for 26 metastases (including 21 lung and 5 lymph node or soft tissue metastases), were treated at our institution with SBRT. Patient- and treatment-related characteristics were collected. Local control (LC), overall survival (OS), distant metastases-free survival (DMFS), and time to initiation of chemotherapy or best supportive care (corrected disease-free survival, cDFS) were assessed. RESULTS: Four-year OS was 54% and median OS was 69 months [95% confidence interval (CI) 20-118 months]. LC of 26 lesions at 4 years was 78%. Median DMFS and cDFS were 17 (95% CI 5-30 months) and 28 months (95% CI 5-52 months), respectively. Disease-free interval < 24 months from primary tumor treatment to first metastasis was the only predictor of reduced LC, cDFS, and OS (p = 0.022, 0.023, and 0.028, respectively). No acute or chronic grade ≥ 3 toxicity was observed. Median follow-up was 36 months (IQR 18-71 months). CONCLUSIONS: In patients with oligometastatic STS, SBRT yields satisfying local control with minimal toxicity. Median OS was 69 months. Repeated SBRT may be considered to extend disease-free and systemic therapy-free interval. Increased time from primary tumor to first metastasis identifies patients with potentially greater benefit from SBRT.
BACKGROUND: Stereotactic body radiotherapy (SBRT) is emerging as a novel treatment option in metastatic soft tissue sarcoma (STS). The aim of our study was to evaluate the effectiveness of exclusive SBRT on disease control and survival in oligometastatic (≤ 3 synchronous lesions) STS. MATERIALS AND METHODS: In total, 16 consecutive patients, accounting for 26 metastases (including 21 lung and 5 lymph node or soft tissue metastases), were treated at our institution with SBRT. Patient- and treatment-related characteristics were collected. Local control (LC), overall survival (OS), distant metastases-free survival (DMFS), and time to initiation of chemotherapy or best supportive care (corrected disease-free survival, cDFS) were assessed. RESULTS: Four-year OS was 54% and median OS was 69 months [95% confidence interval (CI) 20-118 months]. LC of 26 lesions at 4 years was 78%. Median DMFS and cDFS were 17 (95% CI 5-30 months) and 28 months (95% CI 5-52 months), respectively. Disease-free interval < 24 months from primary tumor treatment to first metastasis was the only predictor of reduced LC, cDFS, and OS (p = 0.022, 0.023, and 0.028, respectively). No acute or chronic grade ≥ 3 toxicity was observed. Median follow-up was 36 months (IQR 18-71 months). CONCLUSIONS: In patients with oligometastatic STS, SBRT yields satisfying local control with minimal toxicity. Median OS was 69 months. Repeated SBRT may be considered to extend disease-free and systemic therapy-free interval. Increased time from primary tumor to first metastasis identifies patients with potentially greater benefit from SBRT.
Entities:
Keywords:
Oligometastases; Radiotherapy; Soft tissue sarcoma; Stereotactic body radiotherapy
Authors: Neel P Chudgar; Murray F Brennan; Rodrigo R Munhoz; Peter R Bucciarelli; Kay See Tan; Sandra P D'Angelo; Manjit S Bains; Matthew Bott; James Huang; Bernard J Park; Valerie W Rusch; Prasad S Adusumilli; William D Tap; Samuel Singer; David R Jones Journal: J Thorac Cardiovasc Surg Date: 2017-03-21 Impact factor: 5.209
Authors: Niraj Mehta; Michael Selch; Pin-Chieh Wang; Noah Federman; Jay M Lee; Fritz C Eilber; Bartosz Chmielowski; Nzhde Agazaryan; Michael Steinberg; Percy Lee Journal: Sarcoma Date: 2013-10-01