Outcomes Following Combined Modality Treatment to the Primary Site in Select Patients With Metastatic Soft Tissue Sarcoma.
| Title: | Outcomes Following Combined Modality Treatment to the Primary Site in Select Patients With Metastatic Soft Tissue Sarcoma. |
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| Authors: | Arifin AJ; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas; Division of Radiation Oncology, Verspeeten Family Cancer Centre/Western University, London, Ontario, Canada.; Bishop AJ; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.; Mitra D; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.; Yoder A; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.; Araujo DM; Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.; Haddad EFN; Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.; Ratan R; Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.; Livingston JA; Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.; Lewis VO; Department of Orthopedic Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.; Lin PP; Department of Orthopedic Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.; Moon BS; Department of Orthopedic Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.; Keung EZ; Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.; Roland CL; Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.; Scally CP; Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.; Mericli AF; Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.; Guadagnolo BA; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.; Farooqi AS; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas. Electronic address: AFarooqi@mdanderson.org. |
| Source: | Practical radiation oncology [Pract Radiat Oncol] 2026 Mar-Apr; Vol. 16 (2), pp. 169-175. Date of Electronic Publication: 2026 Jan 24. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Elsevier Country of Publication: United States NLM ID: 101558279 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-8519 (Electronic) Linking ISSN: 18798500 NLM ISO Abbreviation: Pract Radiat Oncol Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: New York : Elsevier |
| MeSH Terms: | Sarcoma*/therapy ; Sarcoma*/pathology ; Sarcoma*/mortality ; Soft Tissue Neoplasms*/therapy ; Soft Tissue Neoplasms*/pathology ; Soft Tissue Neoplasms*/mortality; Combined Modality Therapy/methods ; Humans ; Female ; Male ; Middle Aged ; Retrospective Studies ; Adult ; Aged ; Treatment Outcome ; Neoplasm Metastasis |
| Abstract: | Purpose: Select patients with metastatic soft tissue sarcoma (STS) may benefit from more aggressive treatment of their primary tumor. We report on the use of combined modality treatment (CMT) using preoperative radiation therapy (RT) followed by surgery to improve local control.; Methods and Materials: We retrospectively reviewed the data of 19 patients with metastatic STS consecutively treated at our institution with CMT between 2018 and 2023. All patients received moderately hypofractionated 40.05 Gy in 15 fractions followed by surgery. Patients were selected for CMT based on factors that were likely to predict longer survival despite having metastatic disease such as oligometastatic disease (≤5 lesions) and favorable response to systemic therapy.; Results: The median size of the primary tumor was 7.6 cm (IQR, 4.4-12.7 cm). Fourteen patients (74%) received systemic therapy immediately before (n = 10) or after (n = 4) CMT. Seven patients (37%) underwent additional metastasis-directed local therapy following CMT to other sites. Pain reduction after CMT was documented in 89% of patients who presented with pain (n = 8 of 9). Median follow-up was 21 months. Two-year local recurrence-free survival, progression-free/distant recurrence-free survival, and overall/cancer-specific survival were 92%, 29%, and 65%, respectively. One patient (5%) had local recurrence. For patients who were not planned to have adjuvant systemic therapy, median systemic therapy-free survival was 15 months. The rate of wound complications within 120 days of surgery was 16%. No planned adjuvant therapy was delayed because of wound complications; all patients commenced systemic therapy within 3 months of surgery. The rate of late RT toxicities was 26%; there were no grade ≥3 late toxicities.; Conclusions: For properly selected patients with metastatic STS with good performance status and long expected survival, a CMT strategy for the primary tumor with moderately hypofractionated preoperative RT offers favorable local control, low toxicity, and pain mitigation without significant effect on systemic therapy resumption.; (Copyright © 2025 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.) |
| Grant Information: | K12 CA088084 United States CA NCI NIH HHS |
| Entry Date(s): | Date Created: 20260124 Date Completed: 20260313 Latest Revision: 20260512 |
| Update Code: | 20260512 |
| PubMed Central ID: | PMC13158947 |
| DOI: | 10.1016/j.prro.2025.12.008 |
| PMID: | 41579133 |
| Database: | MEDLINE |
Journal Article