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.