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Stereotactic radiotherapy for soft tissue and bone sarcomas: real-world evidence

INTRODUCTION: Selected patients with locally advanced or metastatic soft tissue and bone sarcomas (STBS) may benefit from intensive local treatment, such as stereotactic radiotherapy (SRT). This study aimed to summarize the utilization and outcomes of SRT in STBS and to identify predictive factors f...

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Autores principales: Spałek, Mateusz Jacek, Teterycz, Paweł, Borkowska, Aneta, Poleszczuk, Jan, Rutkowski, Piotr
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8848098/
https://www.ncbi.nlm.nih.gov/pubmed/35186124
http://dx.doi.org/10.1177/17588359211070646
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author Spałek, Mateusz Jacek
Teterycz, Paweł
Borkowska, Aneta
Poleszczuk, Jan
Rutkowski, Piotr
author_facet Spałek, Mateusz Jacek
Teterycz, Paweł
Borkowska, Aneta
Poleszczuk, Jan
Rutkowski, Piotr
author_sort Spałek, Mateusz Jacek
collection PubMed
description INTRODUCTION: Selected patients with locally advanced or metastatic soft tissue and bone sarcomas (STBS) may benefit from intensive local treatment, such as stereotactic radiotherapy (SRT). This study aimed to summarize the utilization and outcomes of SRT in STBS and to identify predictive factors for progression and survival. MATERIALS AND METHODS: Consecutive patients with advanced STBS who underwent STBS in a sarcoma tertiary center were identified. We collected tumor- and treatment-related factors. Endpoints comprised time to local progression (TTLP), local progression-free survival (LPFS), time to progression, progression-free survival, and overall survival (OS). The Cox proportional-hazards model was used to identify prognostic factors. RESULTS: We identified 141 patients who underwent 233 SRTs. Median follow-up was 21 months. Local and distant progression occurred after 19 and 163 SRTs, respectively. SRT for lung metastases was predictive for better TTLP and LPFS (hazard ratio, HR = 0.12, p = 0.007 and HR = 0.42, p = 0.002, respectively). Bone sarcoma (HR for TTLP = 3.18, p = 0.043; HR for LPFS = 1.99, p = 0.028) and lower administered dose (HR for TTLP = 0.98, p = 0.007; HR for LPFS = 0.99, p = 0.012) were predictive for worse TTLP and LPFS. SRT for oligometastases (HR = 0.46, p = 0.021) and lung metastases (HR = 0.55, p = 0.046) was predictive for better OS, whereas diagnosis of bone sarcoma (HR = 2.05, p = 0.029) was predictive for worse OS. CONCLUSION: SRT provides excellent local control in STBS patients without significant toxicity. Patients with oligometastatic disease, lung metastases, and soft tissue sarcomas benefit the most from SRT. The dose escalation moderately enhances local control; however, it does not translate into better survival.
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spelling pubmed-88480982022-02-17 Stereotactic radiotherapy for soft tissue and bone sarcomas: real-world evidence Spałek, Mateusz Jacek Teterycz, Paweł Borkowska, Aneta Poleszczuk, Jan Rutkowski, Piotr Ther Adv Med Oncol Original Research INTRODUCTION: Selected patients with locally advanced or metastatic soft tissue and bone sarcomas (STBS) may benefit from intensive local treatment, such as stereotactic radiotherapy (SRT). This study aimed to summarize the utilization and outcomes of SRT in STBS and to identify predictive factors for progression and survival. MATERIALS AND METHODS: Consecutive patients with advanced STBS who underwent STBS in a sarcoma tertiary center were identified. We collected tumor- and treatment-related factors. Endpoints comprised time to local progression (TTLP), local progression-free survival (LPFS), time to progression, progression-free survival, and overall survival (OS). The Cox proportional-hazards model was used to identify prognostic factors. RESULTS: We identified 141 patients who underwent 233 SRTs. Median follow-up was 21 months. Local and distant progression occurred after 19 and 163 SRTs, respectively. SRT for lung metastases was predictive for better TTLP and LPFS (hazard ratio, HR = 0.12, p = 0.007 and HR = 0.42, p = 0.002, respectively). Bone sarcoma (HR for TTLP = 3.18, p = 0.043; HR for LPFS = 1.99, p = 0.028) and lower administered dose (HR for TTLP = 0.98, p = 0.007; HR for LPFS = 0.99, p = 0.012) were predictive for worse TTLP and LPFS. SRT for oligometastases (HR = 0.46, p = 0.021) and lung metastases (HR = 0.55, p = 0.046) was predictive for better OS, whereas diagnosis of bone sarcoma (HR = 2.05, p = 0.029) was predictive for worse OS. CONCLUSION: SRT provides excellent local control in STBS patients without significant toxicity. Patients with oligometastatic disease, lung metastases, and soft tissue sarcomas benefit the most from SRT. The dose escalation moderately enhances local control; however, it does not translate into better survival. SAGE Publications 2022-02-14 /pmc/articles/PMC8848098/ /pubmed/35186124 http://dx.doi.org/10.1177/17588359211070646 Text en © The Author(s), 2022 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Research
Spałek, Mateusz Jacek
Teterycz, Paweł
Borkowska, Aneta
Poleszczuk, Jan
Rutkowski, Piotr
Stereotactic radiotherapy for soft tissue and bone sarcomas: real-world evidence
title Stereotactic radiotherapy for soft tissue and bone sarcomas: real-world evidence
title_full Stereotactic radiotherapy for soft tissue and bone sarcomas: real-world evidence
title_fullStr Stereotactic radiotherapy for soft tissue and bone sarcomas: real-world evidence
title_full_unstemmed Stereotactic radiotherapy for soft tissue and bone sarcomas: real-world evidence
title_short Stereotactic radiotherapy for soft tissue and bone sarcomas: real-world evidence
title_sort stereotactic radiotherapy for soft tissue and bone sarcomas: real-world evidence
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8848098/
https://www.ncbi.nlm.nih.gov/pubmed/35186124
http://dx.doi.org/10.1177/17588359211070646
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