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Radiation Oncology: Updates, Innovations & Controversies

(P 322) STEREOTACTIC BODY RADIOTHERAPY IN METASTATIC SARCOMA

Location: The Liffey, Level 1
Objective: The aim of this study was to retrospectively review the results of stereotactic body radiotherapy (SBRT) in 44 metastatic patients diagnosed with primary sarcoma at the Karolinska University Hospital. between the years 2008 and 2022. Overall response rate, overall survival and side effects were analyzed in 44 patients with a total number of 84 metastases.

Methods: A retrospective review was performed in 44 individual patients at the Karolinska University Hospital diagnosed between 2008-2022. Overall response rate, overall survival and side effects were analyzed in 44 patients with a total number of 84 metastases. The prescribed doses to the CTV were analyzed and the total number of fractions. The overall response (CR, PR, SD=local control) and PD was studied in each specific lesion as well as overall survival and side effects in each patient.

Results: Prescribed doses ranged from 6-17 Gy in 1-8 fractions with total doses of 12-51 Gy. Overall response rate at 6 months (local control= CR, PR and SD) for each tumor was 90%. Thirty-five metastases showed CR. The treated lesions were localized mainly in the lungs and liver. Median follow up was 27 months (3-150) months. Thirteen patients (29,5%) were long-term survivors and were still alive at last follow-up. The side effects were usually mild-moderate but 3 patients had grade 3 pneumonitis and 4 patients had rib fractures. One patient had a lethal grade 5 hemorrhage from the lung.
Compared to our previous study the patients reviewed in this study had significantly smaller tumors, the tumors were treated with higher doses and the median overall survival was longer, 29,5 months versus 26,3 months.

Conclusion: We conclude that SBRT is a relatively safe and effective alternative to surgery in patients with metastatic sarcoma, however the optimal dose-fractionation schemes for lung and liver metastasis remain to be established. The primary cause of failure in this patient group was the development of new metastases.