Reirradiation for soft tissue sarcomas

Abstract

The incidence of local recurrence after wide local excision and radiation of soft tissue sarcoma ranges from 5 to 20 %. Up to 80 % of these relapses will occur in the absence of metastatic disease. The optimal management of locally recurrent soft tissue sarcoma must be individualized and depends on prior therapy, the location of the recurrence, and the feasibility of conservative surgery. Following retreatment, the likelihood of ultimate local control ranges from 37 to 100 % and is a reflection of well-known risk factors for de novo sarcomas such as the number of prior recurrences, high grade, positive margins, deep location, and non-extremity tumor site. Reirradiation as part of a multimodality retreatment strategy may improve the chance of local control and organ preservation, but its use must be balanced with the risk of severe treatment-related side effects. Various reirradiation techniques have been utilized for salvage treatment, each with unique risks and benefits.