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Updated: Sep 18, 2025
Stereotactic Radiosurgery for Gynecologic Cancer
Published on: April 17, 2012
Clinical outcomes following stereotactic radiosurgery for brain metastases from sarcoma primaries: An international
Raj Singh1, John G Roubil2, Greg Bowden3
1Department of Radiation Oncology, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Background:
There is a paucity of data on treatment outcomes following stereotactic radiosurgery (SRS) for brain metastases from sarcoma primaries.
Methods:
The International Radiosurgery Research Foundation member-sites were queried for patients with brain metastases from sarcoma primaries treated with SRS. Overall survival (OS) and local control (LC) were calculated via Kaplan-Meier analysis. Univariate analyses examined prognostic factors associated with LC and OS via log-rank t-tests and multivariate analyses (MVA) via Cox proportional hazards model.
Results:
A total of 146 patients with 309 brain metastases were identified. Two-hundred and thirty lesions were treated with single-fraction SRS with a median dose of 20 Gy (15-24 Gy). Ninety-five patients had extracranial metastases, including 75 oligometastatic patients. One- and 2-year OS and LC rates were 47.7% and 37.3%, and 78.3% and 62.2%, respectively. On univariate analyses, superior 1-year OS was noted among leiomyosarcomas (69.7% vs. 42.6%; p = .02) with poorer outcomes among pleomorphic histologies (10.5% vs. 50.7%; p = .002). Pleomorphic histologies were associated with poorer OS on MVA (hazard ratio [HR], 3.13; p = .006). On MVA, LC was inferior among patients of age ≥45 years (HR, 3.78; p < .001) and superior among leiomyosarcomas (HR, 0.31; p = .03). OS was prognosticated based on adverse factors (ie, nonleiomyosarcoma histology and progressive extracranial metastases). Two-year OS for patients with and without adverse features were 78.6% and 31.5%, respectively.
Conclusions:
LC outcomes were driven by histology and age with superior LC among leiomyosarcomas and patients of age <45 years. OS was driven by nonleiomyosarcoma histology and the presence of progressive extracranial disease.
Insights
Stereotactic radiosurgery (SRS) for brain metastases from sarcoma offers limited data. Leiomyosarcoma histology and younger age (<45) improved local control, while non-leiomyosarcoma histology and extracranial disease worsened overall survival.
Area of Science:
- Neuro-oncology
- Radiation Oncology
- Sarcoma Research
Background:
- Limited data exists on stereotactic radiosurgery (SRS) outcomes for brain metastases originating from sarcoma.
- Sarcoma brain metastases represent a significant clinical challenge with few established treatment guidelines.
Purpose of the Study:
- To evaluate treatment outcomes, including overall survival (OS) and local control (LC), following SRS for brain metastases from sarcoma.
- To identify prognostic factors influencing survival and local control in this patient population.
Main Methods:
- Retrospective analysis of 146 patients with sarcoma brain metastases treated with SRS across International Radiosurgery Research Foundation sites.
- Kaplan-Meier analysis for OS and LC; univariate and multivariate Cox proportional hazards models to identify prognostic factors.
Main Results:
- One- and 2-year OS rates were 47.7% and 37.3%, respectively; 1- and 2-year LC rates were 78.3% and 62.2%, respectively.
- Leiomyosarcoma histology and age <45 years were associated with superior LC (HR, 0.31; P=.03 and HR, 3.78; P<.001, respectively).
- Non-leiomyosarcoma histology (HR, 3.13; P=.006) and progressive extracranial metastases were associated with poorer OS.
Conclusions:
- Local control after SRS for sarcoma brain metastases is influenced by histology and patient age.
- Overall survival is significantly impacted by non-leiomyosarcoma histology and the presence of progressive extracranial disease.
