Purpose: We present our single-institution experience of sarcomatous brain metastasis patients who underwent stereotactic radiosurgery (SRS) over the past 35 years. Methods: In total, 31 patients (16 males) who underwent SRS for sarcoma brain metastases were identified. Median age at presentation to SRS was 47 (range: 4–78) months. Common histopathologies included leiomyosarcoma (eight patients), osteosarcoma (six patients), alveolar sarcoma (three patients), Ewing sarcoma (three patients), and undifferentiated/unclassified sarcoma (three patients). The median Karnofsky Performance Score (KPS) was 90. Nine patients underwent pre-SRS craniotomy. The median dose prescribed was 18 Gy. The median cumulative tumor volume was 1.4 cc. Results: Median patient overall survival (OS) after SRS was 7 (range: 0–155) months. Local tumor control (LTC) was achieved in 105 out of 113 tumors, at a median time of 3 (range: 0–17) months between SRS and progression. LTC rates per patient and per tumor were 74.2% and 92.9%, respectively. Following SRS, 10 patients (32.3%) developed new tumors at a median time of 6 (range: 1–25) months. Four patients experienced adverse radiation effects (AREs). At the last follow-up, all patients died, one patient from intracranial progression, 27 from systemic disease progression, and the remaining from unrelated medical conditions. Conclusions: Given high LTC and low ARE rates, this suggests SRS as a strong candidate for the non-invasive management of sarcomatous brain metastases, which typically present late following initial presentation of the primary disease.
目的：本文回顾性分析我院过去35年间接受立体定向放射外科（SRS）治疗的肉瘤脑转移患者的临床资料。方法：共纳入31例（男性16例）接受SRS治疗的肉瘤脑转移患者。接受SRS治疗时的中位年龄为47个月（范围：4-78个月）。常见病理类型包括平滑肌肉瘤（8例）、骨肉瘤（6例）、腺泡状肉瘤（3例）、尤文肉瘤（3例）及未分化/未分类肉瘤（3例）。中位卡氏功能状态评分（KPS）为90分。9例患者在SRS治疗前接受过开颅手术。处方中位剂量为18 Gy。中位累积肿瘤体积为1.4 cc。结果：SRS治疗后患者中位总生存期（OS）为7个月（范围：0-155个月）。113个肿瘤中有105个获得局部肿瘤控制（LTC），从SRS治疗到进展的中位时间为3个月（范围：0-17个月）。按患者和按肿瘤计算的LTC率分别为74.2%和92.9%。SRS治疗后，10例患者（32.3%）出现新发肿瘤，中位时间为6个月（范围：1-25个月）。4例患者出现放射性不良反应（AREs）。末次随访时所有患者均已死亡，其中1例死于颅内进展，27例死于全身性疾病进展，其余死于非相关疾病。结论：鉴于较高的LTC率和较低的ARE发生率，本研究提示SRS可作为肉瘤脑转移非侵入性治疗的重要选择，此类转移灶通常在原发疾病晚期出现。
Stereotactic Radiosurgery for Patients with Brain Metastases from Sarcomas
肿瘤(癌症)患者之家