ArticleFrontiers in oncology2026
Case report: Beyond arrhythmia: STAR-inspired single-fraction cardiac radioablation for Ewing sarcoma metastasis.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Stereotactic arrhythmia radioablation (STAR) has emerged as an effective non-invasive treatment for refractory ventricular arrhythmias, but its ablative single-fraction regimen may also be relevant beyond electrophysiologic indications. We report the application of a STAR-inspired 25 Gy single-fraction cardiac radioablation approach for right-ventricular metastasis from Ewing sarcoma, presented as a CARE-compliant case report. Case presentation: A 26-year-old man with a history of limb Ewing sarcoma developed an incidentally detected right-ventricular mass during routine staging. After partial surgical debulking, multimodal imaging confirmed a 17 × 15 mm residual intracavitary lesion. Because complete surgical resection was not technically feasible, frameless stereotactic body radiotherapy (SBRT) was delivered in a single 25 Gy fraction using STAR workflow principles. Treatment was completed without complication. At 12-month MRI the lesion was reduced (8 × 10 mm), and subsequent imaging confirmed persistent local cardiac control. At 31 months after STAR, the patient remained free of cardiac symptoms and signs of cardiac disease progression. Conclusion: Adapting the STAR single-fraction regimen for oncologic cardiac targets is feasible and provided durable control with no observed cardiac toxicity. This experience supports further evaluation of STAR-inspired SBRT for unresectable cardiac tumors.
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