Sarcoma

Abstract

The current paradigm for curative management of soft tissue sarcomas (STS) consists of resection plus local radiation treatment for close or positive margins or high-grade disease. Chemotherapy is added for high-risk patients. Skin reaction tends to be the greatest challenge in the acute management of STS patients during radiation therapy; between 60 and 90 % of them develop some degree of acute radiation dermatitis. Other acute reactions in these patients can include abscess formation, seroma, and wound complications. Factors reported to impact acute skin reaction include bolus, radiation dose, use of systemic agents, and volume of skin receiving more than 4000 cGy. Preoperative radiation therapy has been associated with a high incidence of wound-healing complications. Late reactions can include hyperpigmentation, fibrosis, radiation recall, joint stiffness, and progressive lymphedema. The different modalities of radiation treatment confer different risks of late toxicity. Postoperative radiation therapy has been associated with a higher chance of fibrosis.