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Background <p>Brain metastases (BM) from sarcoma are rare and associated with poor prognosis. Stereotactic radiosurgery (SRS) has increasingly been utilized as a local treatment modality; however, outcome data remain limited and heterogeneous.</p> Methods <p>This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature search was performed using Google Scholar, PubMed, Embase, Scopus, and Cochrane. A total of 1,502 records were identified, including Google Scholar (<i>n</i> = 999), PubMed (<i>n</i> = 142), Embase (<i>n</i> = 208), Scopus (<i>n</i> = 149), and Cochrane (<i>n</i> = 4). After the removal of 196 duplicate records using Covidence, 1306 studies underwent title and abstract screening. Of these, 1187 were excluded, and 31 articles were sought for full-text retrieval. A total of nine studies met the inclusion criteria and were included in this systematic review.</p> Results <p>A total of 272 patients, male-predominant, with about 745 BM from sarcoma were treated with SRS. Overall local tumor control (LTC) rates ranged from 81% to 92.9%. Three-month LTC varied between 78% and 100%, while 6-month LTC ranged from 52% to 90.9%. One-year LTC demonstrated substantial variability (0-78.3%), and limited data reported 2-year LTC of 62.2%. Overall survival (OS) outcomes were inconsistently reported. Six-month OS ranged from 50% to 61%, and 1-year OS ranged from 22% to 61%. Two-year OS ranged from 29% to 37.3%. Median OS durations ranged from 6.1 to 16 months. Extracranial metastases, tumor volume, spindle cell and pleomorphic histology, number of brain metastases, age, and hemorrhagic lesions were significant prognostic factors. The adverse events were low-grade and infrequent.</p> Conclusion <p>No standardized treatment strategy currently exists for sarcoma BM. Available evidence suggests that SRS provides survival outcomes comparable to surgical management while offering a less invasive treatment option. However, given the heterogeneity and limited quality of existing studies, further research is needed to better define optimal management strategies.</p> Clinical trial number <p>Not applicable.</p>

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Treatment outcomes of stereotactic radiosurgery for sarcoma brain metastases—systematic review

  • 期刊论文

  • 发表日期：

    2026年3月24日

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  • Muhammad Izhar,
  • Ahed H. Kattaa,
  • Yusuke S. Hori,
  • Fred C. Lam,
  • Neeraj Kalra,
  • Nirmeen Zagzoog,
  • Armine Tayag,
  • Louisa Ustrzynski,
  • Sara C. Emrich,
  • David J. Park,
  • Steven D. Chang

摘要

Background

Brain metastases (BM) from sarcoma are rare and associated with poor prognosis. Stereotactic radiosurgery (SRS) has increasingly been utilized as a local treatment modality; however, outcome data remain limited and heterogeneous.

Methods

This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature search was performed using Google Scholar, PubMed, Embase, Scopus, and Cochrane. A total of 1,502 records were identified, including Google Scholar (n = 999), PubMed (n = 142), Embase (n = 208), Scopus (n = 149), and Cochrane (n = 4). After the removal of 196 duplicate records using Covidence, 1306 studies underwent title and abstract screening. Of these, 1187 were excluded, and 31 articles were sought for full-text retrieval. A total of nine studies met the inclusion criteria and were included in this systematic review.

Results

A total of 272 patients, male-predominant, with about 745 BM from sarcoma were treated with SRS. Overall local tumor control (LTC) rates ranged from 81% to 92.9%. Three-month LTC varied between 78% and 100%, while 6-month LTC ranged from 52% to 90.9%. One-year LTC demonstrated substantial variability (0-78.3%), and limited data reported 2-year LTC of 62.2%. Overall survival (OS) outcomes were inconsistently reported. Six-month OS ranged from 50% to 61%, and 1-year OS ranged from 22% to 61%. Two-year OS ranged from 29% to 37.3%. Median OS durations ranged from 6.1 to 16 months. Extracranial metastases, tumor volume, spindle cell and pleomorphic histology, number of brain metastases, age, and hemorrhagic lesions were significant prognostic factors. The adverse events were low-grade and infrequent.

Conclusion

No standardized treatment strategy currently exists for sarcoma BM. Available evidence suggests that SRS provides survival outcomes comparable to surgical management while offering a less invasive treatment option. However, given the heterogeneity and limited quality of existing studies, further research is needed to better define optimal management strategies.

Clinical trial number

Not applicable.