继发于肉瘤的脑转移（BMs）罕见，其发生率在所有骨骼和软组织肉瘤中为1%至8%。虽然立体定向放射外科（SRS）广泛用于BMs治疗，但有关SRS用于肉瘤转移至脑部的文献很少。本研究的目的是评估SRS治疗肉瘤BMs的安全性和有效性。作者对2005年1月至2022年9月期间，接受手术后作为辅助治疗或作为原发治疗的经组织病理学确诊为肉瘤的BM患者的临床和放射学结局进行了回顾性评估，并比较了出血性病灶和非出血性病灶的结局。 共有23例（9名女性）患者接受了CyberKnife SRS治疗，BM总数为150个。治疗时的中位年龄为48.22岁（范围4-76岁）。最常见的原发肿瘤部位为心脏、肺部、子宫、上肢、胸部壁和头颈部。在首次就诊时的中位Karnofsky生活质量评分为73.28（范围40-100）。8例患者接受SRS作为原发治疗，15例作为手术后辅助治疗。病变的中位体积为24.1 cm3（范围0.1-150.3 cm3），中位边界剂量为24 Gy（范围18-30 Gy），以中位3D等剂量线的76%给予中位1次（范围1-5次）治疗。中位随访时间为8个月（范围2-40个月）。中位无进展生存期和总生存期分别为5.3个月（范围0.4-32个月）和8.2个月（范围0.1-40个月）。所有病变的3、6和12个月局部肿瘤控制（LTC）率分别为78%、52%和30%。没有放射引起的不良反应。在3、6和12个月的随访中，无出血性病灶的患者（分别为100%、70%和40%）的LTC明显优于有出血性病灶的患者（分别为68%、38%和23%）。SRS作为肉瘤BMs的原发治疗和手术后腔内辅助治疗是一种安全且相对有效的治疗方式。非出血性病灶的局部肿瘤控制明显优于出血性病灶。鼓励进行更大规模的研究以验证这些结果。

Brain metastases (BMs) secondary to sarcoma are rare, and their incidence ranges from 1% to 8% of all bone and soft tissue sarcomas. Although stereotactic radiosurgery (SRS) is widely used for BMs, only a few papers have reported on SRS for sarcoma metastasizing to the brain. The purpose of this study was to evaluate the safety and effectiveness of SRS for sarcoma BM.The authors retrospectively reviewed the clinical and radiological outcomes of patients with BM secondary to histopathologically confirmed sarcoma treated with SRS, either as primary treatment or as adjuvant therapy after surgery, at their institution between January 2005 and September 2022. They also compared the outcomes of patients with hemorrhagic lesions and of those without.Twenty-three patients (9 females) with 150 BMs secondary to sarcoma were treated with CyberKnife SRS. Median age at the time of treatment was 48.22 years (range 4-76 years). The most common primary tumor sites were the heart, lungs, uterus, upper extremities, chest wall, and head and neck. The median Karnofsky Performance Status on presentation was 73.28 (range 40-100). Eight patients underwent SRS as a primary treatment and 15 as adjuvant therapy to the resection cavity. The median tumor volume was 24.1 cm3 (range 0.1-150.3 cm3), the median marginal dose was 24 Gy (range 18-30 Gy) delivered in a median of 1 fraction (range 1-5) to a median isodose line of 76%. The median follow-up was 8 months (range 2-40 months). Median progression-free survival and overall survival were 5.3 months (range 0.4-32 months) and 8.2 months (range 0.1-40), respectively. The 3-, 6-, and 12-month local tumor control (LTC) rates for all lesions were respectively 78%, 52%, and 30%. There were no radiation-induced adverse effects. LTC at the 3-, 6-, and 12-month follow-ups was better in patients without hemorrhagic lesions (100%, 70%, and 40%, respectively) than in those with hemorrhagic lesions (68%, 38%, and 23%, respectively).SRS, both as a primary treatment and as adjuvant therapy to the resection cavity after surgery, is a safe and relatively effective treatment modality for sarcoma BMs. Nonhemorrhagic lesions show better LTC than hemorrhagic lesions. Larger studies aiming to validate these results are encouraged.