Hoang Andrew, Wei Zhishuo, Hadjipanayis Constantinos G, Niranjan Ajay, Lunsford L Dade
School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA.
Center for Image-Guided Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
Cancers (Basel). 2025 Jun 24;17(13):2118. doi: 10.3390/cancers17132118.
We present our single-institution experience of sarcomatous brain metastasis patients who underwent stereotactic radiosurgery (SRS) over the past 35 years.
In total, 31 patients (16 males) who underwent SRS for sarcoma brain metastases were identified. Median age at presentation to SRS was 47 (range: 4-78) months. Common histopathologies included leiomyosarcoma (eight patients), osteosarcoma (six patients), alveolar sarcoma (three patients), Ewing sarcoma (three patients), and undifferentiated/unclassified sarcoma (three patients). The median Karnofsky Performance Score (KPS) was 90. Nine patients underwent pre-SRS craniotomy. The median dose prescribed was 18 Gy. The median cumulative tumor volume was 1.4 cc.
Median patient overall survival (OS) after SRS was 7 (range: 0-155) months. Local tumor control (LTC) was achieved in 105 out of 113 tumors, at a median time of 3 (range: 0-17) months between SRS and progression. LTC rates per patient and per tumor were 74.2% and 92.9%, respectively. Following SRS, 10 patients (32.3%) developed new tumors at a median time of 6 (range: 1-25) months. Four patients experienced adverse radiation effects (AREs). At the last follow-up, all patients died, one patient from intracranial progression, 27 from systemic disease progression, and the remaining from unrelated medical conditions.
Given high LTC and low ARE rates, this suggests SRS as a strong candidate for the non-invasive management of sarcomatous brain metastases, which typically present late following initial presentation of the primary disease.
我们介绍过去35年在我们单一机构中接受立体定向放射外科治疗（SRS）的肉瘤脑转移患者的经验。
共确定31例接受SRS治疗肉瘤脑转移的患者（16例男性）。接受SRS时的中位年龄为47（范围：4 - 78）个月。常见组织病理学类型包括平滑肌肉瘤（8例患者）、骨肉瘤（6例患者）、肺泡肉瘤（3例患者）、尤因肉瘤（3例患者）以及未分化/未分类肉瘤（3例患者）。中位卡诺夫斯基表现评分（KPS）为90。9例患者在SRS前接受了开颅手术。规定的中位剂量为18 Gy。中位累积肿瘤体积为1.4 cc。
SRS后患者的中位总生存期（OS）为7（范围：0 - 155）个月。113个肿瘤中有105个实现了局部肿瘤控制（LTC），SRS与疾病进展之间的中位时间为3（范围：0 - 17）个月。每位患者和每个肿瘤的LTC率分别为74.2%和92.9%。SRS后，10例患者（32.3%）在中位时间6（范围：1 - 25）个月时出现新肿瘤。4例患者出现放射性不良反应（AREs）。在最后一次随访时，所有患者均死亡，1例死于颅内进展，2例死于全身疾病进展，其余死于无关的医疗状况。
鉴于高LTC率和低ARE率，这表明SRS是肉瘤脑转移非侵入性治疗的有力候选方法，肉瘤脑转移通常在原发性疾病首次出现后较晚发生。
