Implications and opportunities for radiotherapy in soft tissue sarcomas treatment

The belief about radioresistance of soft tissue sarcomas remained unchanged within several decades; however, recent data on heterogeneity of these tumors and radiotherapy effectiveness doubted that. Radiation therapy has been traditionally applied in the postoperative setting after R0 and, especially, R1 resection of tumors more than 5 cm in diameter, mostly for local control improvement. such approach appears to be standard and recommended by many oncological centers. however, preoperative irradiation of sarcomas may have firm theoretical advantages supported by experimental and clinical data. currently, the most promising therapeutic options with external beam radiotherapy are: combination with chemotherapy and targeted treatment; modern radiotherapy technique such as IMRT, intraoperative radiotherapy, brachytherapy; hadron therapy (protons, neutrons, heavy ions); combination with local hyperthermia.