{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T10:13:31Z","timestamp":1787739211060,"version":"build-2784847793"},"reference-count":22,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T00:00:00Z","timestamp":1749686400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Pediatric osteosarcoma is an aggressive bone malignancy that presents significant challenges due to high rates of metastatic disease and relapse. It is often treated with palliative radiotherapy for symptom control, but achieving definitive local control (LC) with radiotherapy alone is challenging given its radioresistance. LC may be potentially improved by utilizing stereotactic body radiation therapy (SBRT) to deliver high biologically equivalent doses (BED).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study evaluated the LC outcomes of pediatric patients with osteosarcoma and unresectable metastatic disease who were treated with SBRT. Progression\u2010free survival (PFS), overall survival (OS), and toxicities were assessed as secondary endpoints.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included seven patients who received 34 courses of SBRT. The median age at diagnosis was 13.1 and 17.1\u00a0years at first SBRT. The common sites for SBRT were extraspinal osseous metastases (56%), pulmonary\/mediastinal (29%), and spine (9%). At a median follow\u2010up of 6\u00a0months on a per\u2010lesion analysis, LC was achieved in 88% of lesions, with four lesions failing locally. All four local failures were found in patients receiving a BED \u226448\u00a0Gy. The median distant PFS was 2.4\u00a0months. Toxicities were present in four patients, all of which resolved with supportive treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our study demonstrated that SBRT is safe and effective at achieving LC in pediatric patients with unresectable metastatic osteosarcoma, though distant progression can limit survival outcomes. Further studies evaluating SBRT in combination with other therapies are needed to address distant progression.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.31834","type":"journal-article","created":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T01:03:31Z","timestamp":1749776611000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Local Control and Toxicity Outcomes After Stereotactic Body Radiation Therapy for Metastatic Osteosarcoma in Pediatric Patients"],"prefix":"10.1002","volume":"72","author":[{"given":"Sohil","family":"Reddy","sequence":"first","affiliation":[{"name":"The Ohio State University College of Medicine  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rituraj","family":"Upadhyay","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology The Ohio State University Wexner Medical Center  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett","family":"Klamer","sequence":"additional","affiliation":[{"name":"Center for Biostatistics, College of Medicine The Ohio State University  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raj","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology The Ohio State University Wexner Medical Center  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Konieczkowski","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology The Ohio State University Wexner Medical Center  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Cripe","sequence":"additional","affiliation":[{"name":"Translational Therapeutics, The Ohio State University Comprehensive Cancer Center  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas D.","family":"Yeager","sequence":"additional","affiliation":[{"name":"Division of Hematology, Oncology, and Bone Marrow Transplant, Nationwide Children's  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan D.","family":"Roberts","sequence":"additional","affiliation":[{"name":"Division of Hematology, Oncology, and Bone Marrow Transplant, Nationwide Children's  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6547-1220","authenticated-orcid":false,"given":"Jennifer H.","family":"Aldrink","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, Department of Surgery Nationwide Children's Hospital, The Ohio State University College of Medicine  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6054-817X","authenticated-orcid":false,"given":"Bhuvana","family":"Setty","sequence":"additional","affiliation":[{"name":"Division of Hematology, Oncology, and Bone Marrow Transplant, Nationwide Children's  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Scharschmidt","sequence":"additional","affiliation":[{"name":"Pediatric Orthopedic Oncology Program, Nationwide Children's  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3311-0129","authenticated-orcid":false,"given":"Joshua","family":"Palmer","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology The Ohio State University Wexner Medical Center  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sujith","family":"Baliga","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology The Ohio State University Wexner Medical Center  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,12]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.sult.2021.05.010"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.59.4895"},{"issue":"4","key":"e_1_2_7_4_1","first-page":"205","article-title":"Bone Cancer: Diagnosis and Treatment Principles","volume":"98","author":"Ferguson J. 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