Stereotactic Body Radiotherapy for Metastatic and Recurrent Ewing Sarcoma and Osteosarcoma

Table 2

Description of definitive treatments.

Histology (solitary versus multiple lesions present)	Patient age at time of SBRT (years)	Concurrent chemotherapy	Location	PTV size (cc)	SBRT total dose (Gy)	Fractions (number)	Local failure (time to failure, years)	Overall disease status (F/U, years)	Time to F/U imaging^1  (years)	Acute toxicity (grade)	Late toxicity (grade)
Metastatic OGS (solitary)	17.7	Gemcitabine and docetaxel	Iliac wing	13	50	5	No	NED (2.0)	2.0	None	Myonecrosis (2), pain (2), neuropathy (2)
Metastatic OGS (solitary)	9.8	Ifosfamide and etoposide	Femoral head	43	60	10	No	NED (1.6)	1.6	Erythema (1)	AVN (2), pathologic fracture (2)
Metastatic OGS (solitary)	23.8	None	Hilum	24	50	5	No	AWD (3.5)	3.5	None	None
Metastatic OGS (multiple)	66.4	None	S1	175	30	3	Yes (0.4)	DOD (0.8)	0.4	None	None
Metastatic OGS (multiple)	66.4	None	L3	99	30	3	Yes (0.1)	DOD (0.8)	0.1	None	None
Metastatic OGS (multiple)	17.3	None	Iliac crest	11	60	10	No	DOD (0.6)	None	None	None
Metastatic OGS (multiple)	4.9	None	Sacrum	18	50	5	No	DOD (0.3)	0.2	None	None
Recurrent ES (solitary)^3	23.1	None	Sacrum	91	60	10	No	AWD (2.0)	2.0	None	Neuropathy (3)
Metastatic ES (multiple)^4	15.9	None	T11	5.6	30	5	No	NED (4.0)	4.0	None	Myelodysplastic syndrome
Metastatic ES (multiple)	19.7	Vincristine, topotecan, and cytoxan	RUL	1.5	40	5	No	DOD (0.6)	0.3	None	None
Metastatic ES (multiple)	19.7	Vincristine, topotecan, and cytoxan	RLL	2.3	40	5	No	DOD (0.6)	0.3	None	None
Metastatic ES (multiple)^4	30.2	Ifosfamide and etoposide	T1-2	0.7	35	5	No	NED (2.0)	2.0	None	None
Metastatic ES (multiple)^4	30.2	Ifosfamide and etoposide	T5	0.7	35	5	No	NED (2.0)	2.0	None	None
Metastatic ES (multiple)^4	30.2	Ifosfamide and etoposide	T12-L2	4.8	35	5	No	NED (2.0)	2.0	None	None

Continguous similarly bolded/non-bolded rows denote multiple lesions in an individual patient.
Time from SBRT to last follow-up imaging.
²Treatment volume overlapped with field previously irradiated to 40 Gy in 20 fractions for plasmacytoma 6 years before.
³Retreatment of recurrent disease, following 59.4 Gy in 33 fractions to the same region.
⁴SBRT delivered immediately following whole-lung irradiation to 15 Gy in 10 fractions.
⁵Status after contralateral pneumonectomy.
PTV: planning target volume; SBRT: stereotactic body radiotherapy; OGS: osteosarcoma; NED: no evidence of disease; DOD: dead of disease; ES: Ewing sarcoma; RUL: right upper lobe of lung; RLL: right lower lobe of lung; AWD: alive with disease.