Background: The clinical outcome of inoperable sarcoma patients treated with LATTICE (LRT) is limited and therefore the objective of our study was to report treatment response, overall survival (OS), local-recurrence free survival (LRFS) and toxicity.Methods: This retrospective observational study includes 15 histologically proven inoperable non-extremity sarcoma patients with no treatment options or no response to systemic therapy, treated at our institution between 2020 and 2024. The patients were treated with a combination of LRT and normo- or hypo-fractionated external beam radiotherapy. Treatment response was evaluated by RECIST1.1 criteria, toxicity by CTCAE 5.0 and OS and LRFS by Kaplan–Meier curves.Results: The median follow-up (F-UP) since the beginning of the treatment was 10 months (range 4–32). Nine patients were male and six female. Their mean age was 60 years. The median gross tumor volume (GTV) was 1058 cm3(range 142–6103 cm3). The median number of spheres was 9 (4–30). All patients with symptoms reported symptoms’ relief. Based on RECIST1.1 criteria, 10 patients (67%) had stable local disease at 1–2 months F-UP on computed tomography (CT). Surgical resection was feasible in five patients. Three of them are alive without disease and two died due to metastatic progression. From 10 (67%) non operated patients, 5 patients died (50%) due to disease. The remaining five patients (50%) are alive, three with stable disease at 21, 22, and 32 months of F-UP and two with disease progression who are currently receiving palliative chemotherapy treatment. Reported G2 toxicity was as follows: gastrointestinal (2), asthenia (1). Two patients had G3 toxicity: esophagitis (1) and inguinal dermatitis (1). No acute or chronic G4–G5 toxicity was observed.Conclusions: LRT is a feasible and well-tolerated radiation technique for inoperable bulky soft-tissue sarcomas. Further studies are needed to establish protocols to determine which patients could benefit from palliative or preoperative treatment.
背景：对于接受LATTICE放疗（LRT）治疗的不可手术肉瘤患者，其临床结局数据有限，因此本研究旨在报告此类患者的治疗反应、总生存期（OS）、局部无复发生存期（LRFS）及毒性反应。 方法：本回顾性观察研究纳入了2020年至2024年间在我院治疗的15例经组织学证实、无可选治疗方案或对全身治疗无反应的不可手术非肢体肉瘤患者。所有患者均接受了LRT联合常规分割或大分割外照射放疗。治疗反应依据RECIST1.1标准评估，毒性反应依据CTCAE 5.0标准评估，OS和LRFS通过Kaplan-Meier曲线进行分析。 结果：自治疗开始后的中位随访时间为10个月（范围4-32个月）。患者中男性9例，女性6例，平均年龄60岁。肿瘤大体靶区（GTV）中位体积为1058 cm³（范围142-6103 cm³）。中位施源球数量为9个（范围4-30个）。所有有症状患者均报告症状缓解。根据RECIST1.1标准，10例患者（67%）在治疗后1-2个月的计算机断层扫描（CT）随访中显示局部病情稳定。其中5例患者后续实现手术切除，其中3例无病生存，2例因转移进展死亡。在未手术的10例患者（67%）中，5例（50%）因疾病死亡，其余5例（50%）存活，其中3例在随访21、22和32个月时病情稳定，2例出现疾病进展目前正接受姑息性化疗。报告的2级毒性包括：胃肠道反应（2例）、乏力（1例）。2例患者出现3级毒性：食管炎（1例）和腹股沟皮炎（1例）。未观察到急性或慢性4-5级毒性。 结论：LRT对于不可手术的巨大软组织肉瘤是一种可行且耐受性良好的放疗技术。未来需要进一步研究以建立标准方案，明确哪些患者可能从姑息性或术前治疗中获益。
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