[Radiation Therapy for Management of Soft Tissue Sarcomas].

Soft tissue sarcomas (STS) are rare malignancies. STS represent a heterogeneous group of tumors, with many of them posing a high risk of local recurrence and distant metastasis. The major therapeutic goals of treating STS are to maximize local tumor control using minimal surgery and to improve survival. The ability of radiation therapy (RT) to improve local control has made it a cornerstone in the multimodality treatment of STS. Koshy reported survival benefit of RT in patients undergoing limbsparing surgery for soft tissue sarcomas of the extremities. A retrospective study from the Surveillance, Epidemiology, and End Results (SEER) database that included data from 6,960 patients. They reports that radiation was associated with improved survival in patients with high-grade tumors. The randomized study of preoperative versus postoperative radiation therapy conducted by the National Cancer Institute of Canada (NCIC). The radiation therapy techniques consisted of 50 Gy in the preoperative setting and 66 Gy given postoperatively. Patients treated with postoperative radiation therapy tended to have greater fibrosis. Fibrosis, joint stiffness and edema adversely affect patient function. Haas reported the proposed consensus guidelines on target volume delineation with RT for STS in 2012. Particle therapy, intensity-modulated RT (IMRT) and image-guided RT (IGRT) offers the opportunity to reduce the normal tissue morbidity of RT while maintaining local tumor control. In conclusion, the precision with which the radiation dose is distributed with advanced RT has a beneficial effect in sparing normal tissue with improved local control over that achieved with conventional RT.