Soft Tissue Sarcoma Treatments

Question 1

What is the favored treatment option for STS?

Answer 1

Surgery is the favored option compared to others.

Question 2

When is surgery considered definitive for STS?

Answer 2

Surgery is definitive when margins greater than 1 cm are achieved or when the fascial plane is left.

Question 3

What should be done with surgical clips in cases of positive margins?

Answer 3

Surgical clips should remain in the surgical bed to help the radiation oncologist design an optimal treatment plan.

Question 4

What are the advantages of preoperative radiation therapy?

Answer 4

Fields are smaller, may result in less morbidity, lower total dose, reduced risk of seeding, and a thickened pseudo capsule may simplify resection.

Question 5

What is a treatment option for postoperative radiation therapy?

Answer 5

Brachytherapy.

Question 6

What is the recommended dose for low dose rate brachytherapy with negative margins?

Answer 6

45 Gy.

Question 7

How much of a strip must be left for lymphatic drainage return?

Answer 7

A 2cm strip must be left for lymphatic drainage return.

Question 8

What should radiation fields include around the surgical site?

Answer 8

Radiation fields should include the full surgical bed with margins of 3 to 6 cm around the surgical site.

Question 9

What does the boost volume include?

Answer 9

The boost volume includes the primary tumor volume and a 2 to 3cm margin.