Singh Raj, Sierra Robert, Leimbach Casey, Iyer Sidharth, Lehrer Eric J, Perlow Haley, Upadhyay Rituraj, Ma Sung Jun, Sim Austin, Gogineni Emile, Baliga Sujith, Trifiletti Daniel M, Palmer Joshua D, Konieczkowski David J, Brownstein Jeremy, Zaorzky Nicholas G
Department of Radiation Oncology, The James Cancer Hospital at The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA.
J Radiosurg SBRT. 2025;9(3):215-226.
Though promising retrospective and prospective studies have reported on stereotactic ablative radiation therapy(SABR) for management of lung metastases from sarcoma primaries, they are limited by small patient numbers.
The primary outcomes of interest were 1-year and 2-year local control (LC) and Grade 3-5 toxicities. Secondary outcomes were 1-year overall survival (OS) and 2-year OS. Weighted random effects meta-analyses using the DerSimonian and Laird methods were performed to calculate effect sizes.
Thirteen studies were identified with 533 patients and 940 lung metastases. The median prescription dose was 50 Gy (range: 48-60 Gy) in 5 fractions (range: 4-10). Following SABR, 1- and 2-year pooled LC rates were 97% (95% CI: 95-98%) and 91% (95% CI: 88-95%), respectively. Pooled 1- and 2-year OS rates were 85% (95% CI: 80-90%) and 68% (95% CI: 57-80%), respectively. The estimated incidence of Grade 3-5 toxicities following SABR was 0.1% (95% CI: 0-0.5%).
SABR for sarcoma pulmonary metastases resulted in excellent LC with minimal toxicities.
尽管有前景的回顾性和前瞻性研究报告了立体定向消融放疗（SABR）用于治疗肉瘤原发灶的肺转移，但这些研究受限于患者数量较少。
感兴趣的主要结局是1年和2年局部控制（LC）及3 - 5级毒性反应。次要结局是1年总生存（OS）和2年OS。采用DerSimonian和Laird方法进行加权随机效应荟萃分析以计算效应量。
共纳入13项研究，涉及533例患者和940处肺转移灶。中位处方剂量为50 Gy（范围：48 - 60 Gy），分5次给予（范围：4 - 10次）。SABR治疗后，1年和2年的汇总LC率分别为97%（95%CI：95 - 98%）和91%（95%CI：88 - 95%）。1年和2年的汇总OS率分别为85%（95%CI：80 - 90%）和68%（95%CI：57 - 80%）。SABR后3 - 5级毒性反应的估计发生率为0.1%（95%CI：0 - 0.5%）。
SABR治疗肉瘤肺转移可获得极佳的局部控制，且毒性极小。
