[Radiotherapy of soft tissue sarcomas of the extremities]

Radiotherapy is fully integrated in the treatment of soft tissue sarcomas. Nonamputative limb salvage is combined with large-volume, high-dose (65 Gy), pre- or postoperative radiotherapy. The survival rate for the conservative, combined approach to tumors of the extremities is no worse than that of radical or amputative surgery alone. It is better for large tumors to receive irradiation preoperatively, as there is then a higher probability that the limb can be spared at surgery. For tumors less than 10 cm, at doses of greater than 64 Gy radiotherapy alone can attain a local control rate of as much as 50%. With neutron irradiation, half of the patients with nonresectable tumors can be successfully treated locally. Conformal and dynamic treatment techniques will increase the probability that local tumors can be controlled by irradiation alone. The pion treatment technique at SIN is described in some detail.