COMMENT : Radiotherapy in head and neck sarcomas – to be added

Despoina Misailidou





For stage I surgery alone (unless close<1 cm margin or positive margin )then postop RT category III,B(1,2)

For stage II-III resectable surgery plus postop or preop RT category II,A(3,4,5)


1.Respondek P, Pollack A, Feig BW et al: Prospective randomized trial of conservative surgery and selective use of radiotherapy for AJCC T1 extremity and trunk soft tissue sarcomas Sarcoma 1:219,1977

2.Baldini EH, Goldberg J, Jenner C et al: Long term outcomes after function sparing surgery without radiotherapy for soft tissue sarcoma of the extremities and trunk J Clin Oncol 17:3252-3259,1999

3.Pisters PW, Harrison LB, Leung DH et al: Long term results of a prospective randomized trial of adjuvant brachytherapy in soft tissue sarcoma J Clin Oncol 14:859-868, 1996

4.Yang JC, Chang AE, Baker AR et al: A randomized prospective study of the benefit of adjuvant radiation therapy in the treatment of soft tissue sarcomas of the extremity J Clin Oncol  16: 197-205,1998

5.O Sullivan B, Davis AM, Turcotte R et al: Preoperative (50 Gy) vs postoperative (66 Gy) radiotherapy in the soft tissues sarcoma of the limbs. A randomized trial Lancet 359:2235-2241, 2002


No randomized trials

Preop  RT±chemotherapy

Postop RT (IORT 12-15 Gy followed by 45-50 Gy

Category IV, C(6)

6.Ballo MT,Zagars GK et al : Retroperitoneal soft tissue sarcomas. An analysis of radiation and surgical treatment Int J Rad Oncol Physics 67:158-169,2007




Standard treatment is surgery. Postoperative RT may be offered to patients with leiomyosarcoma /undifferentiated stromal sarcoma category IV,C(7)

7.Reed NS, Mangioni C, et al :Phase III randomized study to evaluate the role of adjuvant pelvic radiotherapy in the treatment of uterine sarcomas stage I and II .Eur J Cancer 2008 44:808-818





Surgery .In extraabdominal disease. if positive margin postop RT(50Gy).If inoperable RT 50-60 Gy 5 year control 60-70%

Category V,B(8)


8.Guadognolo BA,Zagars GK ,Ballo MT et al:Long term outcomes for desmoid tumorws treated with radiation therapy IJROBP 71:441-447,2008



Bone Tumors




Inoperable or close/+ margin RT to 60-75 Gy

Category V,D


Ewing´s sarcoma


45-60Gy for unresectable ,inadequate surgical margin and poor histological response (>10% viable tumor cells) category IV,B

Lung mets whole lung RT (1.5/15Gy) 45 Gy Boost Category III,B