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La radiologia medica

, Volume 123, Issue 11, pp 871–878 | Cite as

Stereotactic body radiotherapy for oligometastatic soft tissue sarcoma

  • Mauro Loi
  • Marloes Duijm
  • Sarah Baker
  • Linda Rossi
  • Dirk Grunhagen
  • Cornelis Verhoef
  • Joost Nuyttens
RADIOTHERAPY

Abstract

Background

Stereotactic body radiotherapy (SBRT) is emerging as a novel treatment option in metastatic soft tissue sarcoma (STS). The aim of our study was to evaluate the effectiveness of exclusive SBRT on disease control and survival in oligometastatic (≤ 3 synchronous lesions) STS.

Materials and methods

In total, 16 consecutive patients, accounting for 26 metastases (including 21 lung and 5 lymph node or soft tissue metastases), were treated at our institution with SBRT. Patient- and treatment-related characteristics were collected. Local control (LC), overall survival (OS), distant metastases-free survival (DMFS), and time to initiation of chemotherapy or best supportive care (corrected disease-free survival, cDFS) were assessed.

Results

Four-year OS was 54% and median OS was 69 months [95% confidence interval (CI) 20–118 months]. LC of 26 lesions at 4 years was 78%. Median DMFS and cDFS were 17 (95% CI 5–30 months) and 28 months (95% CI 5–52 months), respectively. Disease-free interval < 24 months from primary tumor treatment to first metastasis was the only predictor of reduced LC, cDFS, and OS (p = 0.022, 0.023, and 0.028, respectively). No acute or chronic grade ≥ 3 toxicity was observed. Median follow-up was 36 months (IQR 18–71 months).

Conclusions

In patients with oligometastatic STS, SBRT yields satisfying local control with minimal toxicity. Median OS was 69 months. Repeated SBRT may be considered to extend disease-free and systemic therapy-free interval. Increased time from primary tumor to first metastasis identifies patients with potentially greater benefit from SBRT.

Keywords

Stereotactic body radiotherapy Oligometastases Soft tissue sarcoma Radiotherapy 

Notes

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

All the authors listed (Mauro Loi, Marloes Duijm, Sarah Baker, Linda Rossi, Dirk Grunhagen, Cornelis Verhoef, Joost Nuyttens) report no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Authorization by the institutional review board was demanded.

Informed consent

Informed consent to the procedures was obtained from all individual participants.

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Copyright information

© Italian Society of Medical Radiology 2018

Authors and Affiliations

  1. 1.Department of Radiation OncologyErasmus MC Cancer InstituteRotterdamThe Netherlands
  2. 2.Department of Surgical OncologyErasmus MC Cancer InstituteRotterdamThe Netherlands

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