[Radiotherapy of soft tissue sarcomas of the extremities and superficial trunk]

Soft tissue sarcomas represent a histopathologically and clinically heterogeneous group of tumors that make up around 1% of malignancies, in which soft tissue sarcomas of the extremities and superficial trunk (STSET) are treated with more or less the same strategy. Over the past 30 years, there has been a migration away from amputation and radical ablative surgical procedures for localized STSET toward more conservative, function-preserving surgery combined with radiotherapy +/- chemotherapy. The latter complex treatment ensures equal local control to radical surgery. This multidisciplinary management includes organ sparing surgery as the main procedure but also radiotherapy of different types applied before, during or after the surgery, chemotherapy depending of the stadium of the tumor and plastic, reconstructive surgery, and last but not least rehabilitation of the patient after treatment. In this publication we overview the practical guidelines for the treatment of STSET based on the available literature from the last decades. Indication and timing of radiotherapy of STSET as well as available external beam and brachytherapy techniques are summarized. The prescribed radiation dose, the role of alternative fractionations, the combination of radiotherapy and systemic chemotherapy, hyperthermia or limb perfusion regards to STSET are also discussed. Practical considerations of radiotherapy, the target volumes and the role of newer radiotherapy technology in STSET treatment are overviewed.