title: Stereotactic radiosurgery, a potential alternative treatment for pulmonary metastases from osteosarcoma.
abstract: Stereotactic radiosurgery (SRS), such as body gamma knife, was reported to achieve excellent rates of local disease control with limited toxicity in many cases of primary or secondary pulmonary tumor, except osteosarcoma. To confirm the value of SRS in pulmonary metastases from osteosarcoma, we reviewed the experience from our institution (Department of Oncology, Affiliated Sixth People's Hospital, Shanghai) and compared the efficiency of SRS with that of surgical resection. From January 2005 to December 2012, we carried out a retrospective investigation of 58 patients (age, 8-59 years; mean, 25.2 years) who were diagnosed with non-metastatic osteosarcoma of the extremity and later developed pulmonary metastasis during the period of adjuvant chemotherapy or follow-up. Among them, 27 patients were treated by SRS using the body gamma-knife system. A total dose of 50 Gy was delivered at 5 Gy/fraction to the 50% isodose line covering the planning target volume, whereas a total dose of 70 Gy was delivered at 7 Gy/fraction to the gross target volume. The other 31 patients were treated by surgical resection. Two-year progression-free survival rate, two-year survival rate, median time of PRPFS (post-relapse progress-free survival) and PROS (post-relapse overall survival) in SRS group were parallel to that in surgical group. All 27 patients tolerated gamma knife radiosurgery well while only 9 patients had grades 1-2 pneumonitis. We believe SRS, compared with surgical resection, is effective and safe in treating pulmonary metastasis from osteosarcoma, especially for those patients who were medically unfit for a resection or who refused surgery.
authors.affiliation: Department of Oncology, Affiliated Sixth People's Hospital, Shanghai Jiaotong University, Xuhui, 200233 Shanghai, P.R. China.
authors.forename: Wenxi
authors.initials: W
authors.lastname: Yu
authors.affiliation: Department of Oncology, Affiliated Sixth People's Hospital, Shanghai Jiaotong University, Xuhui, 200233 Shanghai, P.R. China.
authors.forename: Lina
authors.initials: L
authors.lastname: Tang
authors.affiliation: Department of Oncology, Affiliated Sixth People's Hospital, Shanghai Jiaotong University, Xuhui, 200233 Shanghai, P.R. China.
authors.forename: Feng
authors.initials: F
authors.lastname: Lin
authors.affiliation: Department of Gynecology and Obstetrics, Jiangsu Province Hospital of TCM, Affiliated Hospital of Nanjing University of TCM, 210029 Nanjing, P.R. China.
authors.forename: Dake
authors.initials: D
authors.lastname: Li
authors.affiliation: Department of First General Surgery, People's Hospital of Ma An Shan, Ma An Shan, Anhui, P.R. China.
authors.forename: Jun
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Oncology, Affiliated Sixth People's Hospital, Shanghai Jiaotong University, Xuhui, 200233 Shanghai, P.R. China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Oncology, Affiliated Sixth People's Hospital, Shanghai Jiaotong University, Xuhui, 200233 Shanghai, P.R. China.
authors.forename: Zan
authors.initials: Z
authors.lastname: Shen
mesh_terms: D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000473:pathology*; D017024:Chemotherapy, Adjuvant; D002648:Child; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000532:radiotherapy* / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy; D012516:Osteosarcoma / Q000473:pathology*; D016634:Radiosurgery / Q000009:adverse effects*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult