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Stereotactic Body Radiotherapy Versus Metastasectomy in Patients With Pulmonary Metastases From Soft Tissue Sarcoma
C Tetta1, F Londero2, L R Micali2
1Rizzoli Orthopedic Institute, Bologna, Italy.
Clinical Oncology (Royal College of Radiologists (Great Britain))
|February 7, 2020
Summary
Stereotactic body radiotherapy (SBRT) for lung metastases from soft tissue sarcoma (STS) showed a lower death rate than surgery (metastasectomy). Both treatments offered similar survival times and disease-free rates, but SBRT had a higher rate of survival with disease.
Area of Science:
- Oncology
- Radiotherapy
- Surgical Oncology
Background:
- The lung is the most common site for soft tissue sarcoma (STS) metastasis.
- Effective treatment strategies for lung metastases are crucial for patient outcomes.
Purpose of the Study:
- To systematically review and compare the outcomes of stereotactic body radiotherapy (SBRT) and metastasectomy (MTS) for lung metastases from STS.
Main Methods:
- A systematic review adhering to the PRISMA protocol was conducted.
- Searched major databases (PubMed, Medline, EMBASE, Cochrane, Ovid, Web of Knowledge) for English-language articles up to December 2018.
- Extracted data from 1306 patients (1104 MTS, 202 SBRT).
Main Results:
- SBRT was associated with a lower cumulative death rate (56%) compared to MTS (72%).
- Overall survival time was similar between SBRT (47.6 months) and MTS (46.7 months).
- Disease-free survival rates were comparable (19% MTS vs. 20% SBRT), but SBRT showed a higher rate of survival with disease (15% vs. 5%).
Conclusions:
- Local treatment of pulmonary metastases from STS with SBRT demonstrates a lower overall death rate than MTS.
- SBRT offers comparable overall survival and disease-free survival rates to MTS, but with a higher incidence of survival with disease.
- Further large randomized trials are needed to validate these findings and assess SBRT's role in early-stage disease.
