Contouring for Sarcomas
We will review indications for RT for STS in adults. We will review dosing and contouring rationale for STS in adults. We will review toxicity management and expectations for radiotherapeutic management for STS in adults.
Cases Covered:
(This activity does not include access to the hands-on practice cases.)
Pre-op
70 female from China who presented with recurrent sarcoma after 3 operations in the left thigh for sarcoma. Her first operation was an unplanned excision in 2020 (4 years prior to current presentation) of what was called a low grade spindle cell sarcoma. The size was unclear but appeared to be less than 5 cm. She had wide re-excision with no radiation therapy. In October of 2023 a new 2-3 cm mass was noted in the proximal anterior thigh, distinct from the site of her prior sarcoma. A wide excision was performed in December 2023. Pathology indicated high grade sarcoma and margin status was not commented upon. Patient refused post-operative MRI but agreed to ultrasound which showed no obvious residual tumor. Staging work up was negative for metastases. Staging: T1N0M0G3, Stage II.
Post-Op
78 year old female presents with a painless but rapidly enlarging mass in her left medial thigh. MRI femur/thigh revealed a 3.2 x 2.4 x 4.6 cm mass. Core biopsy was performed and revealed undifferentiated pleomorphic sarcoma within the sartorius muscle. CT chest was negative for metastases. Staging: T1N0M0, G3, Stage II. Case note: The knee joint is not anatomically relevant for this case, but is included for discussion of joint contouring approaches as it is relevant for many extremity cases.
This activity is available from July 31, 2024, through 11:59 p.m. Eastern time on July 30, 2026.
The content was originally presented and recorded on April 19, 2024, at the 2024 ASTRO Annual Refresher Course.
Target Audience
The meeting is designed to meet the interests of practicing radiation oncologists, radiation oncology residents, medical and clinical physicists, radiation therapists, radiation dosimetrists, nurses and all other health professionals involved in the field of radiation oncology.
Learning Objectives
Upon completion of this activity, participants should be able to:
- Apply the contouring principles for soft tissue sarcoma in adults.
- Identify dosing principles for pre operative and post operative RT for STS in adults
- Describe basic indications for RT for STS in adults.
B. Ashleigh Guadagnolo, MD, MPH, is employed by MD Anderson Cancer Centerand received travel compensation from CTOS and ESMO.
The person(s) above served as the developer(s) of this activity. Additionally, the Education Committee had control over the content of this activity. All relevant relationships have been mitigated.
The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council of Continuing Medical Education to provide continuing education to physicians.
ASTRO is awarded Deemed Status by the American Board of Radiology to provide SA-CME as part of Part II Maintenance of Certification.
Available Credit
- 1.25 AMA PRA Category 1 Credit™The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education for physicians. ASTRO designates this Enduring material for a maximum of 1.25 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
- 1.25 Certificate of AttendanceThis activity was designated for 1.25 AMA PRA Category 1 Credit™.
Price
ASTRO members must log in to the ASTRO website to view and receive the member rate.
Member: $99
Member-in-training: $49
Member Student/Grad Student/PGY: $49
Member Postdoctoral Fellow: $49
Nonmember: $149
Policies:
No refunds, extensions, or substitutions will be made for those participants who, for any reason, have not completed the course by the end of the qualification date.
Participants using ASTRO's online courses to satisfy the requirement of a Maintenance of Certification (MOC) program should verify the number, type and availability dates of any course before making a purchase. No refunds, extensions, or substitutions will be made for participants who have purchased courses that do not align with their MOC requirement.
The course and its materials will only be available on the ASTRO website until July 30, 2026, regardless of purchase date. At the expiration of the qualification, participants will no longer have access to the course or its materials. ASTRO reserves the right to remove a course before the end of its qualification period.
Required Hardware/software
One of the two latest versions of Google Chrome, Mozilla Firefox, Internet Explorer or Safari.