Top Line: Is SBRT effective in controlling sarcoma lung metastases?
The Study: We’ve previously seen a phase 2 trial that showed excellent local control (98.5%) of sarcoma lung metastases treated with SBRT. Adding to this data is this retrospective study of 66 patients with 95 metastases treated treated with SBRT for sarcoma lung mets. The ablative regimens were standard and included 18 Gy x 3 for peripheral lesions, 12 Gy x 4 for lesions near the chest wall, 10 Gy x 5 for lesions near the mediastinum or within 2 cm of the proximal bronchial tree (29%), and 7.5 Gy x 8 for ultracentral lesions (22%). Roughly half of patients (50%) had intrathoracic disease only and 55% had oligometastatic disease. The cumulative incidence of local failure was 3.1% at 12 months and 7.4% at 24 months. Larger tumor size and lower BED were associated with a higher risk of local recurrence. Intrathoracic disease only and oligometastatic disease were associated with improved OS. Importantly, there were no grade 3 or higher events.
TBL: SBRT is safe and effective at treating lung metastases from soft tissue sarcoma with <5% risk of local recurrence at 1 year and a low risk of toxicity. | Lebow, Radiother Oncol 2023
The Study: We’ve previously seen a phase 2 trial that showed excellent local control (98.5%) of sarcoma lung metastases treated with SBRT. Adding to this data is this retrospective study of 66 patients with 95 metastases treated treated with SBRT for sarcoma lung mets. The ablative regimens were standard and included 18 Gy x 3 for peripheral lesions, 12 Gy x 4 for lesions near the chest wall, 10 Gy x 5 for lesions near the mediastinum or within 2 cm of the proximal bronchial tree (29%), and 7.5 Gy x 8 for ultracentral lesions (22%). Roughly half of patients (50%) had intrathoracic disease only and 55% had oligometastatic disease. The cumulative incidence of local failure was 3.1% at 12 months and 7.4% at 24 months. Larger tumor size and lower BED were associated with a higher risk of local recurrence. Intrathoracic disease only and oligometastatic disease were associated with improved OS. Importantly, there were no grade 3 or higher events.
TBL: SBRT is safe and effective at treating lung metastases from soft tissue sarcoma with <5% risk of local recurrence at 1 year and a low risk of toxicity. | Lebow, Radiother Oncol 2023