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Review
. 2022 Sep 29;20(1):322.
doi: 10.1186/s12957-022-02781-1.

Stereotactic body radiotherapy for recurrent and oligometastatic soft tissue sarcoma

Xiao-Yao Feng #  1 , Jing Li #  1 , Ao-Mei Li  1 , Sheng-Hua Jing  1 , Xi-Xu Zhu  1 , Zhen Wang  2
Affiliations
Review

Stereotactic body radiotherapy for recurrent and oligometastatic soft tissue sarcoma

Xiao-Yao Feng et al. World J Surg Oncol. .

Abstract

Background: Soft tissue sarcoma (STS) is a malignant tumor of highly heterogeneous mesenchymal origin. STS has a biological pattern and clinical transformation with localized invasive growth and is susceptible to hematogenous metastasis. Local therapeutic strategies may treat recurrent and oligometastatic STS, including surgery and radiation therapy. This study aimed to evaluate the safety and efficacy of stereotactic body radiotherapy (SBRT) for recurrent and oligometastatic STS.

Methods: We retrospectively analyzed 37 recurrent and oligometastatic STS patients with 58 lesions treated with SBRT from 2009 to 2019 at our institution. Oligometastatic is defined as metastatic lesions less than or equal to 3. The primary endpoint was local control (LC); secondary endpoints were survival and toxicity.

Results: The median follow-up was 21.0 months (3.0 to 125.0 months). Among 37 patients, 18 were recurrent patients, and 19 were oligometastatic patients. Median LC was 25.0 months (95% CI 20.0-45.0). The 1-, 2-, and 3-year LC rates were 80.2%, 58.3%, and 46.6%, respectively. Median overall survival (OS) was 24.0 months (95% CI 13.0-28.0), and the survival rates after SBRT were 71.5%, 40.0%, and 29.1% at 1, 2, and 3-year, respectively. Median progression-free survival (PFS) was 10.0 months (95% CI 8.0-15.0 months), PFS rate after SBRT was 43.6%, 26.8%, and 18.4% at 1, 2, and 3 years, respectively. Late grade 3 radiation dermatitis was observed in one patient (2.7%). Using univariate and multivariate COX analysis, better OS, PFS, and LC were obtained in the histologic grade 1(G1) group, and tumor size and a number of lesions influenced LC.

Conclusions: SBRT is a safe and effective treatment for patients with recurrent and oligometastatic STS. Histological grade influences local control and survival. SBRT may be a promising treatment option for recurrent and oligometastatic STS.

Keywords: Oligometastatic; Radiotherapy; Recurrent; Soft tissue sarcoma (STS); Stereotactic body radiotherapy (SBRT).

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Study flow chart
Fig. 2
Fig. 2
Kaplan–Meier analysis of LC (a) and LC of patients with different histologic grade (b), lesions size (c)
Fig. 3
Fig. 3
Kaplan–Meier analysis of OS (a) and OS of patients with different histologic grade (b), number of lesions (c), disease setting (d)
Fig. 4
Fig. 4
Kaplan–Meier analysis of PFS (a) and PFS of patients with different histologic grade (b), number of lesions (c), disease setting (d)
See this image and copyright information in PMC

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