Skip to main content

Advertisement

SpringerLink
Log in

The Evolving Role of Radiation Therapy in Patients with Metastatic Soft Tissue Sarcoma

  • Sarcomas (SR Patel, Section Editor)
  • Published:
Current Oncology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The management of metastatic disease is evolving. As systemic therapies continue to improve, there is increasing recognition that local therapy to distant sites of disease impacts outcomes among many histologies, including sarcoma. Various local therapy strategies exist, but radiation therapy (RT) is particularly critical as it provides a non-invasive, yet locally ablative strategy for metastatic management.

Recent Findings

Various delivery techniques including stereotactic body radiation therapy (SBRT) or hypofractionated RT can escalate the biologic dose while avoiding normal tissues in order to reduce tumor burden, provide durable local control, palliate symptoms, potentially prevent further seeding of metastatic lesions, and potentially prolong survival.

Summary

This review summarizes the current state of the literature on the important role of RT for the treatment of metastatic sarcoma organized by the site of metastatic disease. Particularly for patients presenting with oligometastatic or oligoprogressive disease, consolidative RT is an important local therapy strategy to be considered in a multidisciplinary setting.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Rosenberg SA, Tepper J, Glatstein E, Costa J, Baker A, Brennan M, et al. The treatment of soft-tissue sarcomas of the extremities: prospective randomized evaluations of (1) limb-sparing surgery plus radiation therapy compared with amputation and (2) the role of adjuvant chemotherapy. Ann Surg. 1982;196(3):305–15. https://doi.org/10.1097/00000658-198209000-00009.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Pisters PW, Harrison LB, Leung DH, Woodruff JM, Casper ES, Brennan MF. Long-term results of a prospective randomized trial of adjuvant brachytherapy in soft tissue sarcoma. J Clin Oncol. 1996;14(3):859–68. https://doi.org/10.1200/JCO.1996.14.3.859.

    Article  CAS  PubMed  Google Scholar 

  3. Yang JC, Chang AE, Baker AR, Sindelar WF, Danforth DN, Topalian SL, et al. Randomized prospective study of the benefit of adjuvant radiation therapy in the treatment of soft tissue sarcomas of the extremity. J Clin Oncol. 1998;16(1):197–203. https://doi.org/10.1200/JCO.1998.16.1.197.

    Article  CAS  PubMed  Google Scholar 

  4. Weitz J, Antonescu CR, Brennan MF. Localized extremity soft tissue sarcoma: improved knowledge with unchanged survival over time. J Clin Oncol. 2003;21(14):2719–25. https://doi.org/10.1200/JCO.2003.02.026.

    Article  PubMed  Google Scholar 

  5. Coindre JM, Terrier P, Guillou L, Le Doussal V, Collin F, Ranchere D, et al. Predictive value of grade for metastasis development in the main histologic types of adult soft tissue sarcomas: a study of 1240 patients from the French Federation of Cancer Centers Sarcoma Group. Cancer. 2001;91(10):1914–26. https://doi.org/10.1002/1097-0142(20010515)91:10<1914::aid-cncr1214>3.0.co;2-3.

    Article  CAS  PubMed  Google Scholar 

  6. Zagars GK, Ballo MT, Pisters PW, Pollock RE, Patel SR, Benjamin RS, et al. Prognostic factors for patients with localized soft-tissue sarcoma treated with conservation surgery and radiation therapy: an analysis of 1225 patients. Cancer. 2003;97(10):2530–43. https://doi.org/10.1002/cncr.11365.

    Article  PubMed  Google Scholar 

  7. Vezeridis MP, Moore R, Karakousis CP. Metastatic patterns in soft-tissue sarcomas. Arch Surg. 1983;118(8):915–8. https://doi.org/10.1001/archsurg.1983.01390080023007.

    Article  CAS  PubMed  Google Scholar 

  8. Potter DA, Glenn J, Kinsella T, Glatstein E, Lack EE, Restrepo C, et al. Patterns of recurrence in patients with high-grade soft-tissue sarcomas. J Clin Oncol. 1985;3(3):353–66. https://doi.org/10.1200/JCO.1985.3.3.353.

    Article  CAS  PubMed  Google Scholar 

  9. Adjuvant chemotherapy for localised resectable soft-tissue sarcoma of adults: meta-analysis of individual data. Sarcoma meta-analysis collaboration. Lancet. 1997;350(9092):1647–54.

  10. Woll PJ, Reichardt P, Le Cesne A, Bonvalot S, Azzarelli A, Hoekstra HJ, et al. Adjuvant chemotherapy with doxorubicin, ifosfamide, and lenograstim for resected soft-tissue sarcoma (EORTC 62931): a multicentre randomised controlled trial. Lancet Oncol. 2012;13(10):1045–54. https://doi.org/10.1016/S1470-2045(12)70346-7.

    Article  CAS  PubMed  Google Scholar 

  11. Van Glabbeke M, van Oosterom AT, Oosterhuis JW, Mouridsen H, Crowther D, Somers R, et al. Prognostic factors for the outcome of chemotherapy in advanced soft tissue sarcoma: an analysis of 2,185 patients treated with anthracycline-containing first-line regimens--a European Organization for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group Study. J Clin Oncol. 1999;17(1):150–7. https://doi.org/10.1200/JCO.1999.17.1.150.

    Article  PubMed  Google Scholar 

  12. Judson I, Verweij J, Gelderblom H, Hartmann JT, Schoffski P, Blay JY, et al. Doxorubicin alone versus intensified doxorubicin plus ifosfamide for first-line treatment of advanced or metastatic soft-tissue sarcoma: a randomised controlled phase 3 trial. Lancet Oncol. 2014;15(4):415–23. https://doi.org/10.1016/S1470-2045(14)70063-4.

    Article  CAS  PubMed  Google Scholar 

  13. Seddon B, Strauss SJ, Whelan J, Leahy M, Woll PJ, Cowie F, et al. Gemcitabine and docetaxel versus doxorubicin as first-line treatment in previously untreated advanced unresectable or metastatic soft-tissue sarcomas (GeDDiS): a randomised controlled phase 3 trial. Lancet Oncol. 2017;18(10):1397–410. https://doi.org/10.1016/S1470-2045(17)30622-8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Karavasilis V, Seddon BM, Ashley S, Al-Muderis O, Fisher C, Judson I. Significant clinical benefit of first-line palliative chemotherapy in advanced soft-tissue sarcoma: retrospective analysis and identification of prognostic factors in 488 patients. Cancer. 2008;112(7):1585–91. https://doi.org/10.1002/cncr.23332.

    Article  PubMed  Google Scholar 

  15. Cancer Genome Atlas Research Network. Electronic address edsc, Cancer Genome Atlas Research N. Comprehensive and integrated genomic characterization of adult soft tissue sarcomas. Cell. 2017;171(4):950–65 e28. https://doi.org/10.1016/j.cell.2017.10.014.

    Article  CAS  Google Scholar 

  16. van der Graaf WT, Blay JY, Chawla SP, Kim DW, Bui-Nguyen B, Casali PG, et al. Pazopanib for metastatic soft-tissue sarcoma (PALETTE): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet. 2012;379(9829):1879–86. https://doi.org/10.1016/S0140-6736(12)60651-5.

    Article  CAS  PubMed  Google Scholar 

  17. Demetri GD, von Mehren M, Jones RL, Hensley ML, Schuetze SM, Staddon A, et al. Efficacy and safety of trabectedin or dacarbazine for metastatic liposarcoma or leiomyosarcoma after failure of conventional chemotherapy: results of a phase III randomized multicenter clinical trial. J Clin Oncol. 2016;34(8):786–93. https://doi.org/10.1200/JCO.2015.62.4734.

    Article  CAS  PubMed  Google Scholar 

  18. Kang S, Kim HS, Kim S, Kim W, Han I. Post-metastasis survival in extremity soft tissue sarcoma: a recursive partitioning analysis of prognostic factors. Eur J Cancer. 2014;50(9):1649–56. https://doi.org/10.1016/j.ejca.2014.03.003.

    Article  PubMed  Google Scholar 

  19. Fowler JF. The linear-quadratic formula and progress in fractionated radiotherapy. Br J Radiol. 1989;62(740):679–94. https://doi.org/10.1259/0007-1285-62-740-679.

    Article  CAS  PubMed  Google Scholar 

  20. Abe Y, Urano M, Kenton LA, Kahn J, Willet CG. The accelerated repopulation of a murine fibrosarcoma, FSA-II, during the fractionated irradiation and the linear-quadratic model. Int J Radiat Oncol Biol Phys. 1991;21(6):1529–34. https://doi.org/10.1016/0360-3016(91)90329-3.

    Article  CAS  PubMed  Google Scholar 

  21. Haas RL, Miah AB, LePechoux C, DeLaney TF, Baldini EH, Alektiar K, et al. Preoperative radiotherapy for extremity soft tissue sarcoma; past, present and future perspectives on dose fractionation regimens and combined modality strategies. Radiother Oncol. 2016;119(1):14–21. https://doi.org/10.1016/j.radonc.2015.12.002.

    Article  PubMed  Google Scholar 

  22. Thames HD, Suit HD. Tumor radioresponsiveness versus fractionation sensitivity. Int J Radiat Oncol Biol Phys. 1986;12(4):687–91. https://doi.org/10.1016/0360-3016(86)90081-7.

    Article  CAS  PubMed  Google Scholar 

  23. Brown JM, Carlson DJ, Brenner DJ. The tumor radiobiology of SRS and SBRT: are more than the 5 Rs involved? Int J Radiat Oncol Biol Phys. 2014;88(2):254–62. https://doi.org/10.1016/j.ijrobp.2013.07.022.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Timmerman R, Paulus R, Galvin J, Michalski J, Straube W, Bradley J, et al. Stereotactic body radiation therapy for inoperable early stage lung cancer. JAMA. 2010;303(11):1070–6. https://doi.org/10.1001/jama.2010.261.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Hellman S, Weichselbaum RR. Oligometastases. J Clin Oncol. 1995;13(1):8–10. https://doi.org/10.1200/JCO.1995.13.1.8.

    Article  CAS  PubMed  Google Scholar 

  26. Weichselbaum RR, Hellman S. Oligometastases revisited. Nat Rev Clin Oncol. 2011;8(6):378–82. https://doi.org/10.1038/nrclinonc.2011.44.

    Article  CAS  PubMed  Google Scholar 

  27. Iyengar P, Wardak Z, Gerber DE, Tumati V, Ahn C, Hughes RS, et al. Consolidative radiotherapy for limited metastatic non-small-cell lung cancer: a phase 2 randomized clinical trial. JAMA Oncol. 2018;4(1):e173501. https://doi.org/10.1001/jamaoncol.2017.3501.

    Article  PubMed  Google Scholar 

  28. Gomez DR, Tang C, Zhang J, Blumenschein GR Jr, Hernandez M, Lee JJ, et al. Local consolidative therapy vs. maintenance therapy or observation for patients with oligometastatic non-small-cell lung cancer: long-term results of a multi-institutional, phase II, randomized study. J Clin Oncol. 2019;37(18):1558–65. https://doi.org/10.1200/JCO.19.00201.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Palma DA, Olson R, Harrow S, Gaede S, Louie AV, Haasbeek C, et al. Stereotactic ablative radiotherapy versus standard of care palliative treatment in patients with oligometastatic cancers (SABR-COMET): a randomised, phase 2, open-label trial. Lancet. 2019;393(10185):2051–8. https://doi.org/10.1016/S0140-6736(18)32487-5.

    Article  PubMed  Google Scholar 

  30. • Falk AT, Moureau-Zabotto L, Ouali M, Penel N, Italiano A, Bay JO, et al. Effect on survival of local ablative treatment of metastases from sarcomas: a study of the French sarcoma group. Clin Oncol (R Coll Radiol). 2015;27(1):48–55. https://doi.org/10.1016/j.clon.2014.09.010This is the largest study done to date evaluating the effect of local ablative therapy with radiation or radiofrequency ablation in sarcoma patients presenting with oligometastatic disease. Retrospective analysis of outcomes using propensity scoring shows improved median overall survival in the group which received comprehesnive local treatment to all lesions compared with those who did not.

    Article  CAS  Google Scholar 

  31. Billingsley KG, Burt ME, Jara E, Ginsberg RJ, Woodruff JM, Leung DH, et al. Pulmonary metastases from soft tissue sarcoma: analysis of patterns of diseases and postmetastasis survival. Ann Surg. 1999;229(5):602–10; discussion 10-2. https://doi.org/10.1097/00000658-199905000-00002.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Garcia Franco CE, Torre W, Tamura A, Guillen-Grima F, San-Julian M, Martin-Algarra S, et al. Long-term results after resection for bone sarcoma pulmonary metastases. Eur J Cardiothorac Surg. 2010;37(5):1205–8. https://doi.org/10.1016/j.ejcts.2009.11.026.

    Article  PubMed  Google Scholar 

  33. Baumann BC, Nagda SN, Kolker JD, Levin WP, Weber KL, Berman AT, et al. Efficacy and safety of stereotactic body radiation therapy for the treatment of pulmonary metastases from sarcoma: a potential alternative to resection. J Surg Oncol. 2016;114(1):65–9. https://doi.org/10.1002/jso.24268.

    Article  PubMed  Google Scholar 

  34. Frakulli R, Salvi F, Balestrini D, Parisi A, Palombarini M, Cammelli S, et al. Stereotactic radiotherapy in the treatment of lung metastases from bone and soft-tissue sarcomas. Anticancer Res. 2015;35(10):5581–6.

    CAS  PubMed  Google Scholar 

  35. Lindsay AD, Haupt EE, Chan CM, Spiguel AR, Scarborough MT, Zlotecki RA, et al. Treatment of sarcoma lung metastases with stereotactic body radiotherapy. Sarcoma. 2018;2018:9132359–6. https://doi.org/10.1155/2018/9132359.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. • Navarria P, Ascolese AM, Cozzi L, Tomatis S, D’Agostino GR, De Rose F, et al. Stereotactic body radiation therapy for lung metastases from soft tissue sarcoma. Eur J Cancer. 2015;51(5):668–74. https://doi.org/10.1016/j.ejca.2015.01.061This was one of the initial studies that demonstrated the feasibilty of using SBRT to treat lung metastases in sarcoma patients. With a median follow-up of 65 months, the investigators reported excellent 5-year local control to be 96% following SBRT, with an overall survival at 5 years of 61%.

    Article  PubMed  Google Scholar 

  37. Soyfer V, Corn BW, Shtraus N, Honig N, Meir Y, Kollender J, et al. Single-institution experience of SBRT for lung metastases in sarcoma patients. Am J Clin Oncol. 2017;40(1):83–5. https://doi.org/10.1097/COC.0000000000000103.

    Article  PubMed  Google Scholar 

  38. Chang JY, Li QQ, Xu QY, Allen PK, Rebueno N, Gomez DR, et al. Stereotactic ablative radiation therapy for centrally located early stage or isolated parenchymal recurrences of non-small cell lung cancer: how to fly in a “no fly zone”. Int J Radiat Oncol Biol Phys. 2014;88(5):1120–8. https://doi.org/10.1016/j.ijrobp.2014.01.022.

    Article  PubMed  Google Scholar 

  39. Coleman RE. Metastatic bone disease: clinical features, pathophysiology and treatment strategies. Cancer Treat Rev. 2001;27(3):165–76. https://doi.org/10.1053/ctrv.2000.0210.

    Article  CAS  PubMed  Google Scholar 

  40. Coleman RE. Clinical features of metastatic bone disease and risk of skeletal morbidity. Clin Cancer Res. 2006;12(20 Pt 2):6243s–9s. https://doi.org/10.1158/1078-0432.CCR-06-0931.

    Article  PubMed  Google Scholar 

  41. Foro Arnalot P, Fontanals AV, Galceran JC, Lynd F, Latiesas XS, de Dios NR, et al. Randomized clinical trial with two palliative radiotherapy regimens in painful bone metastases: 30 Gy in 10 fractions compared with 8 Gy in single fraction. Radiother Oncol. 2008;89(2):150–5. https://doi.org/10.1016/j.radonc.2008.05.018.

    Article  PubMed  Google Scholar 

  42. Hartsell WF, Scott CB, Bruner DW, Scarantino CW, Ivker RA, Roach M 3rd, et al. Randomized trial of short- versus long-course radiotherapy for palliation of painful bone metastases. J Natl Cancer Inst. 2005;97(11):798–804. https://doi.org/10.1093/jnci/dji139.

    Article  PubMed  Google Scholar 

  43. van der Linden YM, Lok JJ, Steenland E, Martijn H, van Houwelingen H, Marijnen CA, et al. Single fraction radiotherapy is efficacious: a further analysis of the Dutch Bone Metastasis Study controlling for the influence of retreatment. Int J Radiat Oncol Biol Phys. 2004;59(2):528–37. https://doi.org/10.1016/j.ijrobp.2003.10.006.

    Article  PubMed  Google Scholar 

  44. Gerszten PC, Mendel E, Yamada Y. Radiotherapy and radiosurgery for metastatic spine disease: what are the options, indications, and outcomes? Spine. 2009;34(22 Suppl):S78–92. https://doi.org/10.1097/BRS.0b013e3181b8b6f5.

    Article  PubMed  Google Scholar 

  45. Amdur RJ, Bennett J, Olivier K, Wallace A, Morris CG, Liu C, et al. A prospective, phase II study demonstrating the potential value and limitation of radiosurgery for spine metastases. Am J Clin Oncol. 2009;32(5):515–20. https://doi.org/10.1097/COC.0b013e318194f70f.

    Article  PubMed  Google Scholar 

  46. Bishop AJ, Tao R, Rebueno NC, Christensen EN, Allen PK, Wang XA, et al. Outcomes for spine stereotactic body radiation therapy and an analysis of predictors of local recurrence. Int J Radiat Oncol Biol Phys. 2015;92(5):1016–26. https://doi.org/10.1016/j.ijrobp.2015.03.037.

    Article  PubMed  Google Scholar 

  47. Chang EL, Shiu AS, Mendel E, Mathews LA, Mahajan A, Allen PK, et al. Phase I/II study of stereotactic body radiotherapy for spinal metastasis and its pattern of failure. J Neurosurg Spine. 2007;7(2):151–60. https://doi.org/10.3171/SPI-07/08/151.

    Article  PubMed  Google Scholar 

  48. Gerszten PC, Burton SA, Ozhasoglu C, Welch WC. Radiosurgery for spinal metastases: clinical experience in 500 cases from a single institution. Spine. 2007;32(2):193–9. https://doi.org/10.1097/01.brs.0000251863.76595.a2.

    Article  PubMed  Google Scholar 

  49. Leeman JE, Bilsky M, Laufer I, Folkert MR, Taunk NK, Osborne JR, et al. Stereotactic body radiotherapy for metastatic spinal sarcoma: a detailed patterns-of-failure study. J Neurosurg Spine. 2016;25(1):52–8. https://doi.org/10.3171/2015.11.SPINE151059.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Tao R, Bishop AJ, Brownlee Z, Allen PK, Settle SH, Chang EL, et al. Stereotactic body radiation therapy for spinal metastases in the postoperative setting: a secondary analysis of mature phase 1-2 trials. Int J Radiat Oncol Biol Phys. 2016;95(5):1405–13. https://doi.org/10.1016/j.ijrobp.2016.03.022.

    Article  PubMed  Google Scholar 

  51. Onufrey V, Mohiuddin M. Radiation therapy in the treatment of metastatic renal cell carcinoma. Int J Radiat Oncol Biol Phys. 1985;11(11):2007–9.

    Article  CAS  Google Scholar 

  52. Maor MH, Frias AE, Oswald MJ. Palliative radiotherapy for brain metastases in renal carcinoma. Cancer. 1988;62(9):1912–7.

    Article  CAS  Google Scholar 

  53. Wronski M, Maor MH, Davis BJ, Sawaya R, Levin VA. External radiation of brain metastases from renal carcinoma: a retrospective study of 119 patients from the M. D. Anderson Cancer Center. Int J Radiat Oncol Biol Phys. 1997;37(4):753–9.

    Article  CAS  Google Scholar 

  54. • Folkert MR, Bilsky MH, Tom AK, Oh JH, Alektiar KM, Laufer I, et al. Outcomes and toxicity for hypofractionated and single-fraction image-guided stereotactic radiosurgery for sarcomas metastasizing to the spine. Int J Radiat Oncol Biol Phys. 2014;88(5):1085–91. https://doi.org/10.1016/j.ijrobp.2013.12.042This study examined outcomes for 88 sarcoma patients that were treated to a total of 120 spinal metastatic lesions with spine radiosurgery. Local control at 1 year was noted to be 88% with single-fraction SRS demonstrating improved local control relative to multifraction SRS.

    Article  PubMed  Google Scholar 

  55. Bishop AJ, Tao R, Guadagnolo BA, Allen PK, Rebueno NC, Wang XA, et al. Spine stereotactic radiosurgery for metastatic sarcoma: patterns of failure and radiation treatment volume considerations. J Neurosurg Spine. 2017;27(3):303–11. https://doi.org/10.3171/2017.1.SPINE161045.

    Article  PubMed  Google Scholar 

  56. Wang H, Shiu A, Wang C, O'Daniel J, Mahajan A, Woo S, et al. Dosimetric effect of translational and rotational errors for patients undergoing image-guided stereotactic body radiotherapy for spinal metastases. Int J Radiat Oncol Biol Phys. 2008;71(4):1261–71. https://doi.org/10.1016/j.ijrobp.2008.02.074.

    Article  PubMed  Google Scholar 

  57. Farooqi A, Bishop AJ, Narang S, Allen PK, Li J, McAleer MF, et al. Outcomes after hypofractionated dose-escalation using a simultaneous integrated boost technique for treatment of spine metastases not amenable to stereotactic radiosurgery. Pract Radiat Oncol. 2019;9(2):e142–e8. https://doi.org/10.1016/j.prro.2018.10.008.

    Article  PubMed  Google Scholar 

  58. Thibault I, Campbell M, Tseng CL, Atenafu EG, Letourneau D, Yu E, et al. Salvage stereotactic body radiotherapy (SBRT) following in-field failure of initial SBRT for spinal metastases. Int J Radiat Oncol Biol Phys. 2015;93(2):353–60. https://doi.org/10.1016/j.ijrobp.2015.03.029.

    Article  PubMed  Google Scholar 

  59. Chen H, Pruitt A, Nicol TL, Gorgulu S, Choti MA. Complete hepatic resection of metastases from leiomyosarcoma prolongs survival. J Gastrointest Surg. 1998;2(2):151–5. https://doi.org/10.1016/s1091-255x(98)80006-1.

    Article  CAS  PubMed  Google Scholar 

  60. Lang H, Nussbaum KT, Kaudel P, Fruhauf N, Flemming P, Raab R. Hepatic metastases from leiomyosarcoma: a single-center experience with 34 liver resections during a 15-year period. Ann Surg. 2000;231(4):500–5. https://doi.org/10.1097/00000658-200004000-00007.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  61. Pawlik TM, Vauthey JN, Abdalla EK, Pollock RE, Ellis LM, Curley SA. Results of a single-center experience with resection and ablation for sarcoma metastatic to the liver. Arch Surg. 2006;141(6):537–43; discussion 43-4. https://doi.org/10.1001/archsurg.141.6.537.

    Article  PubMed  Google Scholar 

  62. Kollar LE, Sapir E, Welling TH, Chugh R, Schuetze SM, Lawrence TS, et al. Local management for sarcoma liver metastases. Int J Radiat Oncol Biol Phys. 2015;93(3):E633. https://doi.org/10.1016/j.ijrobp.2015.07.2163.

    Article  Google Scholar 

  63. Rusthoven KE, Kavanagh BD, Cardenes H, Stieber VW, Burri SH, Feigenberg SJ, et al. Multi-institutional phase I/II trial of stereotactic body radiation therapy for liver metastases. J Clin Oncol. 2009;27(10):1572–8. https://doi.org/10.1200/JCO.2008.19.6329.

    Article  PubMed  Google Scholar 

  64. Tao R, Krishnan S, Bhosale PR, Javle MM, Aloia TA, Shroff RT, et al. Ablative radiotherapy doses lead to a substantial prolongation of survival in patients with inoperable intrahepatic cholangiocarcinoma: a retrospective dose response analysis. J Clin Oncol. 2016;34(3):219–26. https://doi.org/10.1200/JCO.2015.61.3778.

    Article  CAS  PubMed  Google Scholar 

  65. Ahmed KA, Freilich JM, Abuodeh Y, Figura N, Patel N, Sarangkasiri S, et al. Fractionated stereotactic radiotherapy to the post-operative cavity for radioresistant and radiosensitive brain metastases. J Neuro-Oncol. 2014;118(1):179–86. https://doi.org/10.1007/s11060-014-1417-2.

    Article  CAS  Google Scholar 

  66. Yaeh A, Nanda T, Jani A, Rozenblat T, Qureshi Y, Saad S, et al. Control of brain metastases from radioresistant tumors treated by stereotactic radiosurgery. J Neuro-Oncol. 2015;124(3):507–14. https://doi.org/10.1007/s11060-015-1871-5.

    Article  CAS  Google Scholar 

  67. Chang EL, Wefel JS, Hess KR, Allen PK, Lang FF, Kornguth DG, et al. Neurocognition in patients with brain metastases treated with radiosurgery or radiosurgery plus whole-brain irradiation: a randomised controlled trial. Lancet Oncol. 2009;10(11):1037–44. https://doi.org/10.1016/S1470-2045(09)70263-3.

    Article  PubMed  Google Scholar 

  68. Brown PD, Jaeckle K, Ballman KV, Farace E, Cerhan JH, Anderson SK, et al. Effect of radiosurgery alone vs radiosurgery with whole brain radiation therapy on cognitive function in patients with 1 to 3 brain metastases: a randomized clinical trial. JAMA. 2016;316(4):401–9. https://doi.org/10.1001/jama.2016.9839.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Kawai A, Araki N, Sugiura H, Ueda T, Yonemoto T, Takahashi M, et al. Trabectedin monotherapy after standard chemotherapy versus best supportive care in patients with advanced, translocation-related sarcoma: a randomised, open-label, phase 2 study. Lancet Oncol. 2015;16(4):406–16. https://doi.org/10.1016/S1470-2045(15)70098-7.

    Article  CAS  PubMed  Google Scholar 

  70. Mir O, Brodowicz T, Italiano A, Wallet J, Blay JY, Bertucci F, et al. Safety and efficacy of regorafenib in patients with advanced soft tissue sarcoma (REGOSARC): a randomised, double-blind, placebo-controlled, phase 2 trial. Lancet Oncol. 2016;17(12):1732–42. https://doi.org/10.1016/S1470-2045(16)30507-1.

    Article  CAS  PubMed  Google Scholar 

  71. Schoffski P, Chawla S, Maki RG, Italiano A, Gelderblom H, Choy E, et al. Eribulin versus dacarbazine in previously treated patients with advanced liposarcoma or leiomyosarcoma: a randomised, open-label, multicentre, phase 3 trial. Lancet. 2016;387(10028):1629–37. https://doi.org/10.1016/S0140-6736(15)01283-0.

    Article  CAS  PubMed  Google Scholar 

  72. Kalbasi A, June CH, Haas N, Vapiwala N. Radiation and immunotherapy: a synergistic combination. J Clin Invest. 2013;123(7):2756–63. https://doi.org/10.1172/JCI69219.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  73. Burgess M, Tawbi H. Immunotherapeutic approaches to sarcoma. Curr Treat Options in Oncol. 2015;16(6):26. https://doi.org/10.1007/s11864-015-0345-5.

    Article  Google Scholar 

  74. Tseng WW, Somaiah N, Engleman EG. Potential for immunotherapy in soft tissue sarcoma. Hum Vaccin Immunother. 2014;10(11):3117–24. https://doi.org/10.4161/21645515.2014.983003.

    Article  PubMed  Google Scholar 

  75. D'Angelo SP, Tap WD, Schwartz GK, Carvajal RD. Sarcoma immunotherapy: past approaches and future directions. Sarcoma. 2014;2014:391967–13. https://doi.org/10.1155/2014/391967.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center Houston, 1515 Holcombe Blvd, Houston, TX, 77030, USA

    Ahsan Farooqi, Devarati Mitra, B. Ashleigh Guadagnolo & Andrew J. Bishop

  2. Health Services Research, The University of Texas MD Anderson Cancer Center Houston, 1515 Holcombe Blvd, Houston, TX, 77030, USA

    B. Ashleigh Guadagnolo

Authors
  1. Ahsan Farooqi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Devarati Mitra
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. B. Ashleigh Guadagnolo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Andrew J. Bishop
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andrew J. Bishop.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Sarcomas

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Farooqi, A., Mitra, D., Guadagnolo, B.A. et al. The Evolving Role of Radiation Therapy in Patients with Metastatic Soft Tissue Sarcoma. Curr Oncol Rep 22, 79 (2020). https://doi.org/10.1007/s11912-020-00936-5

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11912-020-00936-5

Keywords

Search

Navigation