文章：

立体定向体部放射治疗在骨与软组织肉瘤肺转移多模式治疗中的关键作用

The Critical Role of Stereotactic Body Radiation Therapy in Multimodal Treatment of Lung Metastasis from Bone and Soft Tissue Sarcomas

原文发布日期：24 October 2024

DOI: 10.3390/cancers16213593

类型: Article

开放获取: 是

英文摘要：

Background: Stereotactic body radiotherapy (SBRT) is increasingly used to treat lung metastasis (LM) in patients with soft tissue sarcoma (STS) and bone sarcoma (BS). Methods: This retrospective study evaluated the outcomes of patients with BS and STS treated with SBRT for LM between 2010 and 2023. Results: We enrolled 102 patients (51 each with STS and BS), of whom 71 were males and 31 were females (median age, 40 years; range, 11–81 years). At diagnosis, 76 and 26 patients had localized and metastatic disease, respectively, with a median of 4 recurrences (range, 1–12). Before SBRT, 75 patients received chemotherapy and 52 underwent surgery for LM, with 276 nodules treated with SBRT (median dose, 48 Gy; range, 40–52). Local control of irradiated LM was 86% at 1 year and 78% at 2 years. By 31 December 2023 (median follow-up, 4.8 years), 60 patients had died and 42 survived (20 without ongoing disease). From the first LM relapse, the median overall survival (OS) was 4.8 years and the 5-year OS was 49% (95% confidence interval, 39–60%), with no difference between STS and BS; the median OS was 2.9 years and the 5-year OS was 36% after SBRT. Chemotherapy before SBRT was a negative prognostic factor by multivariate analysis. Conclusions: Long-term follow-up shows that SBRT as part of a multimodal treatment approach has reasonable survival rates in patients with LM due to sarcoma. Compared with historical results using only surgery and chemotherapy, SBRT has improved the 5-year OS.

摘要翻译： 

背景：立体定向体部放疗（SBRT）在软组织肉瘤（STS）和骨肉瘤（BS）患者肺转移（LM）治疗中的应用日益广泛。方法：本回顾性研究评估了2010年至2023年间接受SBRT治疗肺转移的BS和STS患者的临床结局。结果：共纳入102例患者（STS与BS各51例），其中男性71例，女性31例（中位年龄40岁，范围11-81岁）。初诊时76例为局限性病变，26例为转移性病变，中位复发次数为4次（范围1-12次）。SBRT治疗前，75例患者接受过化疗，52例曾行肺转移灶切除术，共计276个结节接受SBRT治疗（中位剂量48 Gy，范围40-52 Gy）。放疗后肺转移灶的局部控制率在1年时为86%，2年时为78%。截至2023年12月31日（中位随访时间4.8年），60例患者死亡，42例存活（其中20例无持续性疾病）。自首次肺转移复发起，患者中位总生存期（OS）为4.8年，5年OS率为49%（95%置信区间39-60%），STS与BS患者间无显著差异；SBRT治疗后中位OS为2.9年，5年OS率为36%。多因素分析显示SBRT前接受化疗是负面预后因素。结论：长期随访表明，作为多模式治疗策略的一部分，SBRT在肉瘤肺转移患者中可获得合理的生存率。与既往单纯手术和化疗的历史数据相比，SBRT改善了患者的5年总生存率。

原文链接：

The Critical Role of Stereotactic Body Radiation Therapy in Multimodal Treatment of Lung Metastasis from Bone and Soft Tissue Sarcomas