Radiation Therapy: Neoadjuvant, Adjuvant, or Not at All

Clinical trial data show that radiation enhances local tumor control of extremity sarcomas with acceptable morbidity when sophisticated radiation techniques are combined with limb-sparing resections performed by oncologic surgeons with sarcoma expertise. Similar controlled data is not available for retroperitoneal sarcomas but some studies suggest a benefit for radiotherapy. Radiation can be delivered by external beam or brachytherapy; it can be given pre-operatively, post-operatively, or intra-operatively. Indications for and advances in radiation therapy are discussed in this article.