Overview                                                                   

Sarcomas are cancers of the “connective tissues” of the body which include fat, muscle, cartilage, and blood vessels.  Derived from the Greek word for “fleshy growth”, sarcomas are among the rarest of cancers, comprising <1% of all cancers diagnosed each year in the United States.

One of the most confusing aspects of sarcomas is the enormous variety of tumor types.  In fact, there are over 70 distinct sarcoma histologies (types).  The most common sarcoma is known as a Gastrointestinal Stromal Tumor (GIST), with approximately 3000-3500 cases diagnosed each year. 

Other types of sarcomas include tumors of fat (liposarcoma), muscle (rhabdomyosarcoma), and cartilage (chondrosarcoma).

To learn more about soft tissue sarcomas, check out the American Cancer Society website.

Role of Radiation Therapy                                     

Radiation Therapy occupies an important role in the treatment of sarcomas.  Originally falsely thought to be radioresistant, radiation was only used to palliate sarcoma patients with unresectable disease. 

Today, however, radiation therapy is commonly used either prior to (preoperative) or following (postoperative) surgery in an effort to reduce the risk of recurrence and the need for radical surgery (view paper 1 and paper 2).

The role of radiotherapy is particularly important in patients with extremity soft tissue sarcomas.  In these patients, radiation is combined with surgery (and often with chemotherapy as well) in order to avoid the need for amputation (view paper).  Radiation is also commonly delivered following surgery in patients with retroperitoneal sarcomas (view paper).

Radiation Therapy Techniques                              

The most common radiation technique used today in the treatment of soft tissue sarcomas is 3D conformal radiation therapy (3DCRT).  3DCRT techniques use multiple shaped beams to focus the radiation dose on the target, reducing the dose delivered to surrounding normal tissues.

3DCRT plan in a patient with an upper extremity liposarcoma

An important caveat of the irradiation of all extremity tumors is the need to “spare” a strip of skin (soft tissue) in order to avoid the development of extremity swelling (edema) due to impairment of the draining lymphatics.  In the above example, care is taken to use beam angles ensuring that the entire circumference of the limb is not irradiated.

Sarcoma Publications by UCSD Radiation Oncology Faculty    

Listed below are Sarcoma Articles published by members of the UCSD Department of Radiation Oncology.  For a full list of published articles by UCSD Radiation Oncology faculty see Research section

Memarzadeh S, Mundt AJ, Berek JS. Uterine sarcoma. I.

Memarzadeh S, Mundt AJ, Berek JS. Uterine sarcoma. II.

Mundt AJ, et al.. A Phase I Trial of TNFerade Biologic in Patients with Soft Tissue Sarcoma in the Extremities. Clin Cancer Res 2004;10:5747-53.

Brockstein B, Mundt AJ, et al.  Radiation-induced leiomyosarcoma: does antimetabolite chemotherapy contribute? A report of three cases. Sarcoma 2003;7:167-172

Czyzewski ED, Goldman S, Mundt AJ, et al.  Radiation therapy for consolidation of metastatic or recurrent sarcomas in children treated with intensive chemotherapy and stem cell rescue: a feasibility study.  Int J Radiat Oncol Biol Phys 1999;44:569-577

Gibbs P, Peabody T, Mundt AJ, et al. Oncologic Outcomes of Subcutaneous Sarcomas of the Extremities.  J Bone J Surg 1997;79A:888-897

Mundt AJ, Weichselbaum RR.  Radiation Therapy in Soft Tissue Tumors.  In: Das Gupta T (ed). Soft Tissue Tumors.  Williams & Wilkins, Baltimore, 1996.

Mundt AJ, Weichselbaum RR  et al. Conservative Surgery and Adjuvant Radiation Therapy in the Management of Adult Soft Tissue Sarcoma of the Extremities: Clinical and Radiobiologic Results.  Int J Radiat  Oncol  Biol  Phys 1995;32:977-985

Dhillon MS, Singh DP, Sur RK, Prabhu V, Sandhu APS,  et al. Ewing's sarcoma of the foot bone : An analysis of seven cases. J Contemp Orthopaed 1994;29:127-132

Li C, Crawford S, Mundt AJ, et al. Computer-aided treatment design of a distal upper extremity soft tissue tumor with electron beam radiotherapy. Med Dosim 1993;18:143-8