Clinical outcomes following stereotactic radiosurgery for brain metastases from sarcoma primaries: An international multicenter analysis

Raj Singh¹, John G Roubil², Greg Bowden³, David Mathieu⁴, Louis Carrier⁴, Matthew Shepard⁵, Trent Kite⁵, Rodney E Wegner⁶, Piero Picozzi⁷, Andrea Franzini⁷, Huai-Che Yang^{8

9}, Cheng-Chia Lee^{8

9}, Zhishuo Wei¹⁰, Andrew Hoang¹⁰, Judith Hess¹¹, Bushra Fathima¹¹, Veronica Chiang¹¹, Selcuk Peker¹², Yavuz Samanci¹², Roman Liscak¹³, Gabriela Simonova¹³, Mitch Paro¹⁴, Scott Kamen¹⁴, James McInerney¹⁴, Brad E Zacharia¹⁴, Takuma Sumi¹⁵, Hideyuki Kano¹⁵, Angel Bueno¹⁶, Antonio Dono¹⁶, Angel I Blanco¹⁶, Yoshua Esquenazi¹⁶, Juan Diego Alzate¹⁷, Robert G Briggs¹⁸, Cheng Yu¹⁸, Gabriel Zada¹⁸, Christopher P Cifarelli¹⁹, Daniel T Cifarelli¹⁹, Timoteo Almeida²⁰, Carolina Benjamin²¹, Ronan Costa²¹, Herwin Speckter²², Ivan Gonzalez²², Anais Concepcion Marinho Andrade de Moura²³, Douglas Kondziolka²³, Kenneth Bernstein²⁴, Ahmed Shaaban²⁵, L Dade Lunsford¹⁰, Ajay Niranjan¹⁰, David J Konieczkowski¹, Joshua D Palmer¹, Jason P Sheehan²⁵

Affiliations

¹ Department of Radiation Oncology, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
² Department of Radiation Oncology, Massey Comprehensive Cancer Center, Virginia Commonwealth University Health System, Richmond, Virginia, USA.
³ Department of Neurosurgery, University of Alberta, Edmonton, Alberta, Canada.
⁴ Division of Neurosurgery, Department of Surgery, Université de Sherbrooke, Centre de recherche du CHUS, Sherbrooke, Quebec, Canada.
⁵ Department of Neurosurgery, Allegheny Health Network, Pittsburgh, Pennsylvania, USA.
⁶ Department of Radiation Oncology, Allegheny Health Network Cancer Institute, Allegheny Health Network, Pittsburgh, Pennsylvania, USA.
⁷ Department of Neurosurgery, Humanitas Research Hospital - IRCCS, Milan, Italy.
⁸ Department of Neurosurgery, Neurological Institute, Taipei Veteran General Hospital, Taipei, Taiwan.
⁹ School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
¹⁰ Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
¹¹ Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut, USA.
¹² Department of Neurosurgery, Koc University School of Medicine, Istanbul, Turkey.
¹³ Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech Republic.
¹⁴ Department of Neurosurgery, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA.
¹⁵ Department of Neurosurgery, Dokkyo Medical University, Mibu, Tochigi, Japan.
¹⁶ Vivian L. Smith Department of Neurosurgery, University of Texas Science Center at Houston, Houston, Texas, USA.
¹⁷ Department of Neurosurgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
¹⁸ Department of Neurosurgery, University of Southern California, Los Angeles, California, USA.
¹⁹ Department of Neurosurgery, West Virginia University, Morgantown, West Virginia, USA.
²⁰ Department of Neurosurgery and Radiation Oncology, University of Miami, Miami, Florida, USA.
²¹ Department of Neurosurgery, University of Miami, Miami, Florida, USA.
²² Dominican Gamma Knife Center and Radiology Department, CEDIMAT, Santo Domingo, DR.
²³ Department of Neurosurgery, NYU Langone, New York, New York, USA.
²⁴ Department of Radiation Oncology, NYU Langone, New York, New York, USA.
²⁵ Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, USA.

PMID: 40543045
DOI: 10.1002/cncr.35931

Multicenter Study

Clinical outcomes following stereotactic radiosurgery for brain metastases from sarcoma primaries: An international multicenter analysis

Raj Singh et al. Cancer. 2025.

. 2025 Jul 1;131(13):e35931.

doi: 10.1002/cncr.35931.

Authors

Affiliations

¹ Department of Radiation Oncology, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
² Department of Radiation Oncology, Massey Comprehensive Cancer Center, Virginia Commonwealth University Health System, Richmond, Virginia, USA.
³ Department of Neurosurgery, University of Alberta, Edmonton, Alberta, Canada.
⁴ Division of Neurosurgery, Department of Surgery, Université de Sherbrooke, Centre de recherche du CHUS, Sherbrooke, Quebec, Canada.
⁵ Department of Neurosurgery, Allegheny Health Network, Pittsburgh, Pennsylvania, USA.
⁶ Department of Radiation Oncology, Allegheny Health Network Cancer Institute, Allegheny Health Network, Pittsburgh, Pennsylvania, USA.
⁷ Department of Neurosurgery, Humanitas Research Hospital - IRCCS, Milan, Italy.
⁸ Department of Neurosurgery, Neurological Institute, Taipei Veteran General Hospital, Taipei, Taiwan.
⁹ School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
¹⁰ Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
¹¹ Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut, USA.
¹² Department of Neurosurgery, Koc University School of Medicine, Istanbul, Turkey.
¹³ Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech Republic.
¹⁴ Department of Neurosurgery, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA.
¹⁵ Department of Neurosurgery, Dokkyo Medical University, Mibu, Tochigi, Japan.
¹⁶ Vivian L. Smith Department of Neurosurgery, University of Texas Science Center at Houston, Houston, Texas, USA.
¹⁷ Department of Neurosurgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
¹⁸ Department of Neurosurgery, University of Southern California, Los Angeles, California, USA.
¹⁹ Department of Neurosurgery, West Virginia University, Morgantown, West Virginia, USA.
²⁰ Department of Neurosurgery and Radiation Oncology, University of Miami, Miami, Florida, USA.
²¹ Department of Neurosurgery, University of Miami, Miami, Florida, USA.
²² Dominican Gamma Knife Center and Radiology Department, CEDIMAT, Santo Domingo, DR.
²³ Department of Neurosurgery, NYU Langone, New York, New York, USA.
²⁴ Department of Radiation Oncology, NYU Langone, New York, New York, USA.
²⁵ Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, USA.

PMID: 40543045
DOI: 10.1002/cncr.35931

Abstract

Background: There is a paucity of data on treatment outcomes following stereotactic radiosurgery (SRS) for brain metastases from sarcoma primaries.

Methods: The International Radiosurgery Research Foundation member-sites were queried for patients with brain metastases from sarcoma primaries treated with SRS. Overall survival (OS) and local control (LC) were calculated via Kaplan-Meier analysis. Univariate analyses examined prognostic factors associated with LC and OS via log-rank t-tests and multivariate analyses (MVA) via Cox proportional hazards model.

Results: A total of 146 patients with 309 brain metastases were identified. Two-hundred and thirty lesions were treated with single-fraction SRS with a median dose of 20 Gy (15-24 Gy). Ninety-five patients had extracranial metastases, including 75 oligometastatic patients. One- and 2-year OS and LC rates were 47.7% and 37.3%, and 78.3% and 62.2%, respectively. On univariate analyses, superior 1-year OS was noted among leiomyosarcomas (69.7% vs. 42.6%; p = .02) with poorer outcomes among pleomorphic histologies (10.5% vs. 50.7%; p = .002). Pleomorphic histologies were associated with poorer OS on MVA (hazard ratio [HR], 3.13; p = .006). On MVA, LC was inferior among patients of age ≥45 years (HR, 3.78; p < .001) and superior among leiomyosarcomas (HR, 0.31; p = .03). OS was prognosticated based on adverse factors (ie, nonleiomyosarcoma histology and progressive extracranial metastases). Two-year OS for patients with and without adverse features were 78.6% and 31.5%, respectively.

Conclusions: LC outcomes were driven by histology and age with superior LC among leiomyosarcomas and patients of age <45 years. OS was driven by nonleiomyosarcoma histology and the presence of progressive extracranial disease.

Keywords: brain metastases; local control; overall survival; sarcoma primary; stereotactic radiosurgery.

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References

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Clinical outcomes following stereotactic radiosurgery for brain metastases from sarcoma primaries: An international multicenter analysis

Affiliations

Clinical outcomes following stereotactic radiosurgery for brain metastases from sarcoma primaries: An international multicenter analysis

Authors

Affiliations

Abstract

References

REFERENCES

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical