Radiation Therapy for Treatment of Soft Tissue Sarcoma in Adults: Executive Summary of an ASTRO Clinical Practice Guideline

Abstract

Sources of support: This work was funded by the American Society for Radiation Oncology. Disclosures: All task force members' disclosure statements were reviewed before being invited and were shared with other task force members throughout the guideline's development. Those disclosures are published within this report. Where potential conflicts were detected, remedial measures to address them were taken.

Modeling the propagation of tumor fronts with shortest path and diffusion models -- implications for the definition of the clinical target volume

“…For the final example, a more complex geometry with anisotropy in the tumor spread is introduced. The anisotropy can come from directional tissues that serve as highways for tumor cells, such as white matter tracts for brain tumors (corpus callosum) (Jordan et al, 2019), and muscle fibers for certain types of sarcoma (Salerno et al, 2021).…”

“…The art of defining the CTV has been described in textbooks (Grosu and Nieder, 2015). For specific disease sites, consensus guidelines have been developed (Niyazi et al, 2016;Grégoire et al, 2018;Wang et al, 2011;Salerno et al, 2021). They normally recommend expanding the GTV by a fixed margin, while avoiding anatomical barriers that serve as impenetrable walls for tumor cell spread (Shusharina et al, 2020).…”

“…They normally recommend expanding the GTV by a fixed margin, while avoiding anatomical barriers that serve as impenetrable walls for tumor cell spread (Shusharina et al, 2020). In the case of directional tissues such as white matter tracts in the brain, or muscle fibers, the GTV-CTV expansion guidelines may recommend larger expansions in the direction of preferred spread (Jordan et al, 2019;Wang et al, 2011;Salerno et al, 2021).…”

Retroperitoneal Sarcoma Care in 2021

“…A subsequent retrospective review of the National Cancer Database revealed a survival benefit only in those with high-grade liposarcoma measuring greater than 10 cm receiving radiation in the adjuvant setting [ 109 ]. Additional details regarding dosing, target volumes, techniques, and the overall role of RT in RPS management are outlined in a 2021 review [ 110 ], and summarized within the 2021 American Society of Radiation Oncology clinical practice guidelines for soft-tissue sarcoma [ 111 ]. Further studies are needed to address subgroups of RPS most likely to benefit from adjunctive radiation therapy.…”

Sarcoma Care Collaborations: Models for patient centered sub-specialty oncology care in the COVID-19 era and beyond

“…Consensus and target delineation guidelines for soft tissue sarcomas and retroperitoneal sarcomas provide a framework to promote standardization of quality of care delivered between referral and community centers. 14 In addition, many cooperative group protocols in the pediatric and adult setting for sarcoma require centralized quality assurance peer review prior to treatment, and adherence to protocol guidelines has been shown to result in improved outcomes. 15 In practice, with the increased access to referral centers via telehealth or through virtual sarcoma tumor boards, we can more provide timely radiotherapy recommendations, including often personal discussion with the treating community-based radiation oncologist, particularly when a photon or electron based treatment course is indicated which are more widely available technologies.…”