[Rôle of radiotherapy for sarcomas]

Abstract

The quality of the initial management of sarcomas is fundamental because it conditions the patient's quality of life and his overall survival. Radiotherapy should be discussed in a multidisciplinary consultation meeting within the framework of the Netsarc+network. The place of radiotherapy in patients with soft tissue or bone sarcoma depends on the histology and tumour location, knowing that it is most often associated with surgery which remains the main treatment. It is part of the standard treatment for grade II and III deep limb sarcomas of 5cm or greater in size and Ewing's sarcomas. In these indications, conformal radiotherapy with modulation of intensity is used routinely, in combination with IGRT. In other locations, such as retroperitoneal sarcomas or uterine sarcomas, radiotherapy is not a standard of care and must be discussed according to the prognostic criteria related to the patient, the tumour, and the previously received treatments. New techniques, such as proton therapy, hadron therapy (carbon ions) are techniques particularly suited to bone sarcomas considered to be radioresistant. However, large prospective trials are lacking in these rare indications, explaining the lack of recommendations of a high level of evidence.

Keywords: Bone sarcoma; Intensity-modulated radiation therapy; Postoperative radiotherapy; Preoperative radiotherapy; Proton therapy; Protonthérapie; Radiothérapie avec modulation d’intensité; Radiothérapie postopératoire; Radiothérapie préopératoire; Sarcomes des tissus mous; Sarcomes osseux; Soft tissue sarcoma.