The Role of Radiation in Patients With Soft Tissue Sarcomas

Radiation is a critical component of the treatment strategy for limb salvage of patients with soft tissue sarcoma. In modest dose levels, eg, 60 to 66 Gy, radiation eradicates sarcoma cells in grossly normal tissue that abuts the evident sarcoma and deactivates the microscopic extensions of tumor into adjacent normal tissue. Furthermore, radiation alone at higher dose levels, eg 75 Gy, is effective in patients with small volumes of sarcoma. Clinical experience indicates that the tumor control probability following a specified dose protocol is approximately the same for both epithelial and mesenchymal tumors when they are stratified for tumor volume and clinical presentation and only infiltrative tumors are considered. This provides support for the further use of radiation for this group of patients.