[Radiotherapy of soft tissue sarcoma--part of a multidisciplinary strategy].
The management of soft tissue sarcoma has evolved from a solitary surgical treatment to an interdisciplinary multimodal approach including radiotherapy. These fundamental changes are the result of increased knowledge in tumor biology, radiation sensitivity and the improvement in modern radiation therapy techniques. A successful effective therapy regimen strongly depends on distinct preoperative diagnostics, preoperative conception of the surgical intervention and an experienced oncological team. Of significant importance for the prognosis is early diagnosis as well as tumor excision with a wide negative margin. However, even after complete wide resection in sano, the use of postoperative radiotherapy can further improve local control and should therefore be applied to the majority of patients. Consequently, radiotherapy should only be omitted in cases in which the tumor has been excised with a very wide negative margin; this implies, however, high quality of surgery and distinct histopathological analysis. Patients with non- or questionable resectable tumors, should be referred for pre-operative radiotherapy in order to improve the surgical results. Recent studies have underlined the efficiency of modern radiotherapy regimens. The different radiotherapy regimens will be highlighted against the background of tumor stage and tumor resectibility.
Pape
Hildegard
H
Department of Radiooncology, University of Düsseldorf, and Marien Hospital Düsseldorf, Germany.
Orth
Klaus
K
Engers
Rainer
R
Matuschek
Christiane
C
Müller
Anja
A
Hartmann
Karl-Axel
KA
Gerber
Peter Arne
PA
Lammering
Guido
G
Habermehl
Daniel
D
Fenk
Roland
R
Budach
Wilfried
W
Gripp
Stephan
S
Peiper
Matthias
M
Bölke
Edwin
E
D001918:Brachytherapy; D003131:Combined Modality Therapy; D019583:Dose Fractionation, Radiation; D042241:Early Diagnosis; D006801:Humans; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D010348:Patient Care Team; D011880:Radiotherapy Planning, Computer-Assisted; D018714:Radiotherapy, Adjuvant; D012509:Sarcoma / Q000175:diagnosis / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery