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Sarcoma
Volume 2018, Article ID 9132359, 6 pages
https://doi.org/10.1155/2018/9132359
Research Article

Treatment of Sarcoma Lung Metastases with Stereotactic Body Radiotherapy

1Department of Orthopaedic Surgery, University of Connecticut, Farmington, CT, USA
2Department of Orthopaedic Surgery, University of Florida, Gainesville, FL, USA
3Department of Radiation Oncology, University of Florida, Gainesville, FL, USA

Correspondence should be addressed to Adam D. Lindsay; ude.chcu@yasdnila

Received 9 November 2017; Accepted 4 February 2018; Published 1 April 2018

Academic Editor: Valerae O. Lewis

Copyright © 2018 Adam D. Lindsay et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. The most common site of sarcoma metastasis is the lung. Surgical resection of pulmonary metastases and chemotherapy are treatment options that have been employed, but many patients are poor candidates for these treatments for multiple host or tumor-related reasons. In this group of patients, radiation might provide a less morbid treatment alternative. We sought to evaluate the efficacy of radiotherapy in the treatment of metastatic sarcoma to the lung. Methods. Stereotactic body radiotherapy (SBRT) was used to treat 117 pulmonary metastases in 44 patients. Patients were followed with serial computed tomography imaging of the chest. The primary endpoint was failure of control of a pulmonary lesion as measured by continued growth. Radiation-associated complications were recorded. Results. The majority of patients (84%) received a total dose of 50 Gy per metastatic nodule utilizing an image-guided SBRT technique. The median interval follow-up was 14.2 months (range 1.6–98.6 months). Overall survival was 82% at two years and 50% at five years. Of 117 metastatic nodules treated, six nodules showed failure of treatment (95% control rate). Twenty patients (27%) developed new metastatic lesions and underwent further SBRT. The side effects of SBRT included transient radiation pneumonitis , cough , rib fracture , chronic pain , dermatitis , and dyspnea . Conclusion. Stereotactic body radiotherapy is an effective and safe treatment for the ablation of pulmonary metastasis from sarcoma. Further work is needed to evaluate the optimal role of SBRT relative to surgery or chemotherapy for treatment of metastatic sarcoma.