The Role of Radiation Therapy in the Treatment of Sarcoma of Soft Tissue

Abstract

The treatment of sarcomas of soft tissue has evolved considerably over the years. Initially, as these tumors were often pseudoencapsulated, it was thought that a local excision might be adequate in producing local tumor control. As it was shown that there was a high incidence of local recurrence after local excision alone, surgeons began to treat these tumors with more aggressive resections. Thus, many surgeons began performing amputations at the joint above the tumor in order to maximize local control. Radiation therapy was seldom used as these tumors were thought to be radioresistant. However, over the last 20 years it has become apparent that sarcomas of soft tissue are not radioresistant, and microscopic disease can be controlled in a high percentage of patients with the use of high-dose radiation. Even bulky tumor masses can occasionally be controlled with radiation alone. Thus, there has been a gradual change in treatment policy so that many patients are now treated with the combination of a local resection and radiation therapy. This approach utilizes the ability of the surgical resection to remove the gross tumor and radiation therapy to eradicate microscopic tumor extensions.