SOFT-TISSUE SARCOMAS

This synthesis of the literature on radiotherapy for sarcomas originat ing in the body's soft, supportive tissues, ie, muscle, connective tis sue, and fatty tissue is based on 71 scientific articles, including 4 randomized studies, 5 prospective studies, and 26 retrospective studie s. These studies involve 3444 patients. Over 90% of patients with soft tissue sarcomas in the arms and legs can be treated in a way that pre serves the extremities. Subcutaneous and intramuscular sarcomas can be treated surgically with little functional loss or risk for local recu rrence without adjuvant radiotherapy. To avoid amputation, surgery is often combined with radiotherapy for treatment of local relapse. Adequ ate surgical margins are usually difficult to achieve for head/neck tu mors and retroperitoneal tumors, and therefore surgery is often combin ed with radiotherapy to reduce the risk for local relapse. Pre- and po stoperative radiotherapy are similar (1, 2). A disadvantage of preoper ative radiotherapy is that it reduces the opportunity for exact diagno sis and determining morphobiologic sarcoma parameters. To further impr ove treatment results for advanced sarcomas, it is necessary to introd uce other fractionation schedules, mainly hyperfractionation (1). This places greater demands on radiotherapy, mainly for staff resources. C ombining radiotherapy and local intraarterial chemotherapy involves gr eater risks for complications and has not shown better treatment resul ts than pre- or postoperative radiotherapy alone, and it is not recomm ended as standard treatment for soft tissue sarcomas. Intraoperative t reatment methods should be targeted for further study and development.