Radiotherapy for soft tissue sarcomas

Background:Sarcomas are a heterogeneous group of tumors. Therefore, the optimal therapy sequence has to be determined by specialists on an interdisciplinary basis. Aim:The purpose of this article is to discuss the importance and optimal implementation of radiotherapy in the multimodal treatment concept of sarcomas. Materials and methods:For this purpose, a literature search was performed using current guidelines as well as via PubMed and our own literature database. The sources presented are only a fraction of the available evidence and were selected by the authors. Results:The goal of modern oncologic therapy of sarcomas should be a combination of best oncologic outcome and highest functional preservation. Although surgical resection is the central component of therapy, radiotherapy plays a crucial role in achieving local control and in preserving function. Due to the better side effect profile, irradiation should be performed preoperatively. Radio(chemo)therapy alone may be a curative option. Retroperitoneal sarcomas are excluded; these tend not to benefit from radiation. If radiation is performed, it should be done using modern technology, e.g., intensity-modulated radiotherapy (IMRT), image-guided radiotherapy (IGRT) or volumetric modulated arc therapy (VMAT). Conclusion:Although sarcomas can be curatively treated by surgery or radiation alone, the best results are achieved by multimodality therapy. This shows the importance of good networking among clinics and interdisciplinary collaboration. As a result, waiting times between treatment modalities can be minimized, new scientific findings can be shared more quickly, and fewer patients will miss out on optimal treatment.