title: Radiation Therapy for Soft Tissue Sarcoma: Indications and Controversies for Neoadjuvant Therapy, Adjuvant Therapy, Intraoperative Radiation Therapy, and Brachytherapy.
abstract: Soft tissue sarcomas are rare mesenchymal cancers that pose a treatment challenge. Although small superficial soft tissue sarcomas can be managed by surgery alone, adjuvant radiotherapy in addition to limb-sparing surgery substantially increases local control of extremity sarcomas. Compared with postoperative radiotherapy, preoperative radiotherapy doubles the risk of a wound complication, but decreases the risk for late effects, which are generally irreversible. For retroperitoneal sarcomas, intraoperative radiotherapy can be used to safely escalate the radiation dose to the tumor bed. Patients with newly diagnosed sarcoma should be evaluated before surgery by a multidisciplinary team that includes a radiation oncologist.
authors: Department of Radiation Oncology, Duke University Medical Center, 450 Research Drive, Durham, NC 27708, USA.
authors: Nicole A
authors: NA
authors: Larrier
authors: Department of Radiation Oncology, Duke University Medical Center, 450 Research Drive, Durham, NC 27708, USA.
authors: Brian G
authors: BG
authors: Czito
authors: Department of Radiation Oncology, Duke University Medical Center, 450 Research Drive, Durham, NC 27708, USA; Department of Pharmacology & Cancer Biology, Duke University Medical Center, 450 Research Drive, Durham, NC 27708, USA. Electronic address: david.kirsch@duke.edu.
authors: David G
authors: DG
authors: Kirsch
mesh_terms: D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D003131:Combined Modality Therapy; D006801:Humans; D020360:Neoadjuvant Therapy; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D012509:Sarcoma / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery; D012983:Soft Tissue Neoplasms / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D000903:Antibiotics, Antineoplastic
keywords: Brachytherapy; Intraoperative radiation therapy; Radiation therapy; Sarcoma