背景:软组织肉瘤(STS)是一种高度异质性间充质起源的恶性肿瘤。STS具有局部侵入性生长的生物学模式和临床转化,并且容易发生血行转移。局部治疗策略可以治疗复发性和寡转移性STS,包括手术和放射治疗.本研究旨在评估立体定向放疗(SBRT)治疗复发性和寡转移STS的安全性和有效性。
方法:我们回顾性分析了2009年至2019年在我们机构接受SBRT治疗的37例复发和寡转移的STS患者,其中58个病灶。轻度转移定义为小于或等于3的转移性病变。主要终点是局部控制(LC);次要终点是生存率和毒性。
结果:中位随访时间为21.0个月(3.0至125.0个月)。在37名患者中,18例复发患者,19名是寡转移患者。中位LC为25.0个月(95%CI20.0-45.0)。1-,2-,3年LC率为80.2%,58.3%,和46.6%,分别。中位总生存期(OS)为24.0个月(95%CI13.0-28.0),SBRT后生存率为71.5%,40.0%,1年、2年和3年为29.1%,分别。中位无进展生存期(PFS)为10.0个月(95%CI8.0-15.0个月),SBRT后PFS率为43.6%,26.8%,在1年、2年和3年时为18.4%,分别。在一名患者中观察到晚期3级放射性皮炎(2.7%)。使用单变量和多变量COX分析,更好的操作系统,PFS,在组织学1级(G1)组中获得LC,肿瘤大小和病变数量影响LC。
结论:SBRT对于复发和寡转移的STS患者是一种安全有效的治疗方法。组织学分级影响局部控制和存活。SBRT可能是复发性和寡转移STS的有希望的治疗选择。
BACKGROUND: Soft tissue sarcoma (STS) is a malignant tumor of highly heterogeneous mesenchymal origin. STS has a biological pattern and clinical transformation with localized invasive growth and is susceptible to hematogenous metastasis. Local therapeutic strategies may treat recurrent and
oligometastatic STS, including surgery and radiation therapy. This study aimed to evaluate the safety and efficacy of stereotactic body radiotherapy (SBRT) for recurrent and oligometastatic STS.
METHODS: We retrospectively analyzed 37 recurrent and
oligometastatic STS patients with 58 lesions treated with SBRT from 2009 to 2019 at our institution.
Oligometastatic is defined as metastatic lesions less than or equal to 3. The primary endpoint was local control (LC); secondary endpoints were survival and toxicity.
RESULTS: The median follow-up was 21.0 months (3.0 to 125.0 months). Among 37 patients, 18 were recurrent patients, and 19 were
oligometastatic patients. Median LC was 25.0 months (95% CI 20.0-45.0). The 1-, 2-, and 3-year LC rates were 80.2%, 58.3%, and 46.6%, respectively. Median overall survival (OS) was 24.0 months (95% CI 13.0-28.0), and the survival rates after SBRT were 71.5%, 40.0%, and 29.1% at 1, 2, and 3-year, respectively. Median progression-free survival (PFS) was 10.0 months (95% CI 8.0-15.0 months), PFS rate after SBRT was 43.6%, 26.8%, and 18.4% at 1, 2, and 3 years, respectively. Late grade 3 radiation dermatitis was observed in one patient (2.7%). Using univariate and multivariate COX analysis, better OS, PFS, and LC were obtained in the histologic grade 1(G1) group, and tumor size and a number of lesions influenced LC.
CONCLUSIONS: SBRT is a safe and effective treatment for patients with recurrent and oligometastatic STS. Histological grade influences local control and survival. SBRT may be a promising treatment option for recurrent and
oligometastatic STS.