S1031
Clinical – Sarcoma, skin cancer, malignant melanoma
ESTRO 2026
Digital Poster 395 Stereotactic body radiotherapy vs.
30.2) compared to 13 months (95% CI: 4.0–21.9) in treatment-naïve patients. Longer median survival was associated with fewer lesions (22 months for 1-3 lesions, 95% CI: 16.4-27.6; 13 months for >3 lesions, 95% CI: 0.0-30.5). Repeated SRS treatments conferred longer median survival (23 months, 95% CI: 2.8-43.14) compared to one treatment (5 months, 95% CI 0.00- 10.5). There was no significant difference in median survival for asymptomatic patients (23 months, 95% CI: 0.0-56.2), compared to symptomatic patients (18 months, 95% CI: 3.1-32.9). Median survival for patients with intracranial disease progression was 18 months (95% CI: 3.2-32.8) compared to those with extracranial disease progression (13 months, 95% CI: 7.9-18.1).
metastasectomy for soft tissue and bone sarcoma lung metastases – a systematic review analyzing safety and efficacy Lena Kretzschmar 1 , Maksym Fritsak 1,2 , Philip Heesen 1,2 , Astrid Heusel 1 , Sylvie Bonvalot 3 , Matthias Guckenberger 1 , Aisha Miah 4 , Falk Röder 5,6 , Maria A Smolle 7 , Sebastian M Christ 1 , Siyer Roohani 8,9 1 Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland. 2 Faculty of Medicine, University of Zurich, Zurich, Switzerland. 3 Department of Surgery, Institut Curie, Paris, France. 4 Department of Radiotherapy and Physics, The Royal Marsden Hospital and The Institute of Cancer Research, London, United Kingdom. 5 Department of Radiation Therapy and Radiation Oncology, Paracelsus Medical University Hospital, Salzburg, Austria. 6 Institute of Research and Development of Advanced Radiation Technologies (radART), Paracelsus Medical University, Salzburg, Austria. 7 Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria. 8 Department of Radiation Oncology, Charité-Universitätsmedizin Berlin, Berlin, Germany. 9 BIH Biomedical Innovation Academy, BIH Charité (Junior) Clinician Scientist Program, Berlin Institute of Health der Charité - Universitätsmedizin Berlin, Berlin, Germany Purpose/Objective: Pulmonary metastases (PM) develop in ~30% of sarcoma patients after curative therapy and confer poor prognosis. Surgery and stereotactic body radiotherapy (SBRT) are viable local ablative options, but direct comparative data is limited. This systematic review evaluates oncologic outcomes and toxicities of surgery versus SBRT for sarcoma-derived PM. Material/Methods: We systematically reviewed Medline and references for studies of sarcoma PM treated with surgery or SBRT, according to PRISMA, including publications up to 13th May 2025. Outcomes included local control (LC), progression-/disease-free survival (PFS/DFS), overall survival (OS), and toxicities, with OS data harmonized for pooled analysis. Results: Fifty-six mostly retrospective studies comprising 4,577 patients were included. LC, PFS, and DFS were reported heterogeneously but were generally comparable. Three-year LC was 89.6% for surgery (2 studies) and 90.2% for SBRT (14 studies). PFS/DFS data were sparse yet similar: Four-year PFS was 21% (SBRT) vs. 28% (surgery; 1 study each); 5-year DFS was 12% (SBRT; 1 study) vs. 19% (surgery; 9 studies). SBRT toxicities were generally ≤ CTCAE grade 3, while surgery occasionally caused grade 4–5 events. 5-year
Conclusion: This study highlights the complexity of patients undergoing SRS with survival analysis influenced by long term survivors. Both intracranial and extracranial progression were common, with those having extracranial relapse having a worse survival. Patients who received systemic treatment prior to SRS showed improved median survival, warranting further
investigation. References:
1. Diaz MJ, Mark I, Rodriguez D, Gelman B, Tran JT, Kleinberg G, Levin A, Beneke A, Root KT, Tran AXV, Lucke-Wold B. Melanoma Brain Metastases: A Systematic Review of Opportunities for Earlier Detection, Diagnosis, and Treatment. Life (Basel). 2023 Mar 19;13(3):828. doi: 10.3390/life13030828. PMID: 36983983; PMCID: PMC10053844.2. Bagshaw HP, Ly D, Suneja G, Jensen RL, Shrieve DC. Local control of melanoma brain metastases treated with stereotactic radiosurgery. J Radiosurg SBRT. 2016;4(3):181-190.
PMID: 29296443; PMCID: PMC5658801. Keywords: melanoma, brain metastasis
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