An Analysis of Patient Characteristics and Clinical Outcomes in Primary Pulmonary Sarcoma

Abstract

favorably to such hypofractionation. In this study, we evaluate outcomes after SBRT in patients with metastatic melanoma. Materials/Methods: A retrospective review of all cases of metastatic melanoma treated with SBRT at the study institution was conducted. Tumors were excluded if they were located in the brain, or had less than 3 months follow-up. 20 consecutively treated patients (34 tumors) were identified. SBRT was delivered with fiducial and vertebral anatomy-based targeting to metastatic lesions in the chest (n Z 16), spine (n Z 9), pelvis/ abdomen (n Z 6), H&N (n Z 2), and liver (n Z 1). Six cases of SBRT (5 spine, 1 chest) were in previously irradiated sites, and seven tumors were oligometastases. Radiation dose ranged from 8 Gy x 1 fraction to 9 Gy x 5 fractions; the most common regimen was 8 Gy x 3 (n Z 10). Median treated volume was 46.4 cm 3 (range, 7.8-455.7 cm 3 ). Results: Median follow-up was 20.7 months (range, 3-60.4 months) and median age at time of radiation was 49 (range, 28-88 years). At time of last follow-up, 8 patients were still alive and 12 had died, with median survival of 22.3 months from time of SBRT. Overall, 80% of patients achieved local control; tumor progression was noted in 8 sites at a median time to failure of 19.7 months (range, 2.1 e 34.3 months). All cases of tumor progression occurred in the lung, in patients who developed uncontrolled systemic disease. Site (log-rank p Z 0.008) and size of treated volume (log-rank p Z 0.045) were significant for local control on univariate analysis. No cases of radiation-induced toxicity occurred. Conclusions: SBRT is an acceptable treatment choice for metastatic melanoma, providing durable local tumor control with limited morbidity. Tumors that are larger in size, or located in the lung, had decreased likelihood of long-term control.

Primary pulmonary synovial sarcoma presenting with a large lump mass in the left upper mediastinum: A case report

“…Primary pulmonary synovial sarcoma is rare, constituting <0.5% of all pulmonary malignancies (7) and ~10% of all primary pulmonary sarcomas (8). Primary pulmonary synovial sarcomas may arise from the parenchyma, tracheobronchial tree or pulmonary artery, and are designated as mesenchymal tumors in the World Health Organization classification (9).…”

Primary pulmonary fibrosarcoma: A case report from a Teaching Hospital in Northern Nigeria

“…However, this extensive nature of the disease was not consistent with the normal findings on cardiovascular examination, and thus makes a case for the need for routine cardiac imaging, as well as extensive mediastenal nodal evaluation to rule out locoregional metastasis in these groups of patients. [13] Histological immunohistochemical evaluation and electron microscopy of the tumor cells were available are critical to the diagnosis of the tumor. The tumors are usually highly cellular, consisting of spindle cells with fusiform nuclei arranged in herring-bone or broad fasicular pattern [5] as in this patient.…”

“…[15] Primary pulmonary sarcomas in general have a markedly worse overall survival compared with soft tissue sarcomas of the extremities. [13] An aggressive approach to treatment is advocated in view of this, but radiotherapy and chemotherapy are preferred for the unresectable cases.…”

Sarcoma sinovial monofásico primario pulmonar

“…Leonidas Carrillo-Ñañez, 1 Pamela Carrillo-García, 2 Stephanie Palacios-Ramírez, 3 César Chiang-García 4 Primary pulmonary synovial sarcoma 1 Son tumores sensibles en el 24 % al uso de ifosfamida y doxorrubicina, como tratamiento coadyuvante la radioterapia, y en etapas tempranas la cirugía es la indicación. La recidiva local puede ocurrir como infiltración al mediastino, pericardio o pared torácica.…”