Department of Radiation Oncology, Seoul National University Hospital, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
Radiat Oncol. 2023 Apr 15;18(1):68. doi: 10.1186/s13014-023-02255-y.
The aim of this study was to evaluate the treatment outcomes and potential dose-response relationship of stereotactic body radiation therapy (SBRT) for pulmonary metastasis of sarcoma.
A retrospective review of 39 patients and 71 lesions treated with SBRT from two institutions was performed. The patients had oligometastatic or oligoprogressive disease, or were receiving palliation. Doses of 20-60 Gy were delivered in 1-5 fractions. The local control per tumor (LCpT) was evaluated according to the biologically effective dose with an α/β ratio of 10 (BED) of the prescribed dose (BED ≥ 100 Gy vs. BED < 100 Gy). Clinical outcomes per patient, including local control per patient (LCpP), pulmonary progression-free rate (PPFR), any progression-free rate (APFR), and overall survival (OS) were investigated.
The median follow-up period was 27.2 months. The 1-, 2-, and 3-year LCpT rates for the entire cohort were 100.0%, 88.3%, and 73.6%, respectively. There was no observed difference in LCpT between the two BED groups (p = 0.180). The 3-year LCpP, PPFR, APFR, and OS rates were 78.1%, 22.7%, 12.9%, and 83.7%, respectively. Five (12.8%) patients with oligometastasis had long-term disease-free intervals, with a median survival period of 40.7 months. Factors that were associated with a worse prognosis were oligoprogression (vs. oligometastasis), multiple pulmonary metastases, and simultaneous extrathoracic metastasis.
SBRT for pulmonary metastasis of sarcoma is effective. Some selected patients may achieve durable response. Considerations of SBRT indication and disease extent may be needed as they may influence the prognosis.
本研究旨在评估立体定向体部放疗（SBRT）治疗肉瘤肺转移的治疗效果和潜在的剂量反应关系。
对来自两个机构的 39 名患者的 71 个病灶进行了回顾性研究，这些患者患有寡转移或寡进展性疾病，或正在接受姑息治疗。20-60Gy 的剂量被分为 1-5 个分数给予。根据处方剂量（BED≥100Gy 与 BED<100Gy）的生物有效剂量（α/β 比为 10 的 BED），评估每肿瘤的局部控制率（LCpT）。根据每位患者的临床结果，包括每位患者的局部控制率（LCpP）、肺无进展率（PPFR）、任何无进展率（APFR）和总生存率（OS）进行调查。
中位随访时间为 27.2 个月。整个队列的 1、2、3 年 LCPT 率分别为 100.0%、88.3%和 73.6%。两组 BED 之间的 LCPT 无明显差异（p=0.180）。3 年的 LCPP、PPFR、APFR 和 OS 率分别为 78.1%、22.7%、12.9%和 83.7%。5 例（12.8%）寡转移患者无疾病进展时间较长，中位生存时间为 40.7 个月。与预后较差相关的因素包括寡进展（与寡转移相比）、多发肺转移和同时性胸外转移。
SBRT 治疗肉瘤肺转移是有效的。一些选择的患者可能会获得持久的缓解。考虑 SBRT 适应证和疾病范围可能会影响预后。
