Is SBRT (or SABR) an effective local therapy for lung metastases from soft tissue sarcoma? Despite the tremendous advances in radiation planning and delivery, the ancient connotation of “radioresistant” histology will likely never die. Soft tissue sarcoma is one such histology. In this prospective phase 2 trial, patients with limited metastatic sarcoma (5 or fewer total lesions in the body), a controlled primary, and 4 or fewer lung metastases ≤5 cm were treated with SBRT. In total, there were 41 patients with 71 lung metastases. Most had 1 (56.8%) or 2 (29.6%) lung metastases, and these were treated with 48 Gy in 4 fractions (85.9%), 60 Gy in 3 fractions (4.2%), or 60 Gy in 8 fractions for central lesions (9.9%). Local control at 12 months was 98.5%, and local recurrence free survival was 58.8% at 12 months. In other words, sarcoma lung metastases aren’t so resistant to ablative doses of radiation. | Navarria, Int J Radiat Oncol Biol Phys 2022


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