Radiation Therapy for Soft Tissue Sarcoma

Radiation therapy can aid in managing soft tissue sarcoma in a variety of ways. It might be used as the sole treatment if an underlying health condition, such as heart disease, prevents you from undergoing surgery. More often, radiation therapy is combined with surgery and chemotherapy to treat the tumor.

Your doctor may recommend radiation therapy to treat soft tissue sarcoma in the arm or leg before performing limb sparing surgery. Radiation therapy before surgery, or neoadjuvant radiation, may help shrink the tumor, making it possible to save the limb.

Often, determining whether to use radiation therapy depends on the type and location of soft tissue sarcoma. For example, NYU Langone radiation oncologists offer prone radiation therapy for sarcoma of the breast and Gamma Knife^® radiosurgery for sarcoma that has spread to the brain.

To tailor a treatment plan for you, NYU Langone radiation oncologists use CT scans to create three-dimensional computerized images of the sarcoma and surrounding tissue and organs. These computerized images allow doctors to treat a “virtual patient” first to determine how best to target the sarcoma and spare healthy tissue.

Frequent CT scans during your treatments help your doctors to ensure that radiation therapy precisely targets the sarcoma and avoids healthy tissue in the arms or legs, as well as important organs such as the lungs or heart. This approach, called image-guided radiation therapy, also helps to compensate for organ movement during treatment caused by breathing, for example.

NYU Langone doctors may use external beam radiation therapy, which is delivered to the tumor from outside the body using a machine called a linear accelerator. This machine rotates around you during therapy. Our doctors may also use brachytherapy, which delivers radiation from within the body.

Intensity Modulated Radiation Therapy

Tumors are often irregularly shaped. Intensity modulated radiation therapy uses a linear accelerator and allows your doctor to sculpt radiation beams of different adjustable intensities in three dimensions to conform to the tumor. Targeting the tumor in this way keeps healthy nearby tissues from being treated, reducing the risk of side effects.

At NYU Langone, intensity modulated radiation therapy is usually delivered once a day, five days a week, for several weeks. Breaking the treatment into doses called fractions helps to deliver enough radiation to treat the tumor while reducing the risk of side effects.

Stereotactic Body Radiation Therapy

This form of treatment delivers a few high doses, or fractions, of carefully targeted radiation beams to the tumor within a period of one to two and a half weeks. It’s typically used for smaller sarcomas that have spread to the lung and for people who aren’t good candidates for surgery.

Brachytherapy

Rarely, a tumor is located near a critical blood vessel or nerve that cannot be sacrificed during surgery. If so, NYU Langone doctors may use brachytherapy. This internal form of radiation requires placement of plastic catheters, or tubes, where the sarcoma had been surgically removed. These tubes run from the inside of your body to the outside through a small incision in the skin.

After surgery, a radioactive ribbon is placed through the catheters near any possible remaining cancer cells and removed after a short time. This can prevent the tumor from coming back. Treatments typically occur about twice a day for up to three days.

In some people, doctors may choose to use brachytherapy after surgery for sarcomas of the arms and legs. This treatment approach potentially avoids many weeks of external beam radiation therapy.

Your team of NYU Langone doctors can plan radiation treatment to minimize common side effects, such as peeling of the skin or nausea and vomiting. Our experts at Rusk Rehabilitation are available to help manage any complications of treatment, such as swelling of the arms and legs or stiffness in the joints caused by scar tissue.