Sarcoma&nbsp;&nbsp;&nbsp;

Would you recommend radiation therapy for an adult patient with rhabdomyosarcoma (embryonal) of the upper extremity s/p amputation with multiple lymph node involvement and ENE on pathology?

The patient is in their 40s with right arm rhabdomyosarcoma s/p amputation. Path shows embryonal rhabdomyosarcoma 6.5 cm, margins neg. 11 of 19 lymph ...

Would you offer dose reduction to 36 Gy pre-op to a lower extremity low grade myxoid liposarcoma based on results of the DOREMY non-randomized data?

Do you offer neoadjuvant radiation therapy for oral cavity sarcoma?

If so, what dose/fractionation? Pathology: High grade spindle cell sarcoma

Would you recommend post op radiation therapy for a primary pulmonary synovial sarcoma which underwent lobectomy?

Relevant pathology features: 7.5cm, grade 3 with a 5mm bronchial margin, negative nodes.

For primary angiosarcoma of the breast following mastectomy, what would your targets be for adjuvant radiation therapy?

Would you cover the chest wall alone or would it be chest wall plus regional nodes? Patient factors: no prior radiation therapy

What techniques and dose constraints do you utilize to limit lower extremity neuropathy when providing post op radiation following soft tissue sarcoma resection?

Relevant pathology features: positive margin Total dose prescription: 66 Gy

0 Answers available

Is there a role for adj RT in a pleomorphic dermal sarcoma after WLE?

If there were negative margins, what other factors would you consider to add adjuvant RT? Size of the tumor or depth of invasion?

What is your local control approach to localized relapse of Ewing sarcoma in a site that was previously unresectable and received definitive radiation?

For unresectable radiation induced angiosarcoma, what dose and fractionation would you use?

Angiosarcoma is invading the brachial plexus and thoracic vertebral bodies. Prior radiation therapy: Radiation to the left chest wall and regional no...

How would you manage primary breast osteosarcoma?

What is the role of local control +/- whole lung irradiation in a patient with relapsed/refractory Ewing sarcoma to the hilum plus multiple lung nodules?

Patient initially achieved CR with VAC-IE with resolution of presumed lung mets and 100% necrosis in LLE primary tumor on BKA. Then was NED again afte...

How would you approach an adult patient >50 years old with an intermediate risk extremity T2N0 fusion neg rhabdomyosarcoma who is progressing on neoadjuvant chemotherapy with VAC?

How would you add radiation in your treatment paradigm? No clinical trials available due to age.

What adjuvant therapy would you recommend for a patient with a sarcomatoid carcinoma of the submandibular gland after R1 resection?

No lymph node dissection. cN0

Would you offer adjuvant radiation for a low-grade cutaneous leiomyosarcoma after R0 resection?

When would you consider adjuvant radiation therapy for tenosynovial giant cell tumors of the extremity?

Would you treat a knee?

What is your treatment approach for a pediatric patient with uterine embryonal rhabdomyosarcoma found after removal of a prolapsing uterine mass, with no evidence of distant metastasis on imaging?

Would you favor post op radiation therapy for soft tissue sarcoma if a positive margin were still expected despite pre-op radiation?

Tumor factor: Large axillary soft tissue sarcoma with involvement of the brachial plexus Other factor: Surgery would like to pursue upfront surgery t...

How would you manage an adult patient status post subtotal resection of spinal osteoblastoma?

The patient presented with spinal cord compression, had subtotal resection and instrumentation with metallic hardware. Main concern is that post op su...

What treatment would you recommend for a patient with recurrent oligometastatic abdominal leiomyosarcoma, with two liver lesions?

No evidence of distant disease elsewhere. Surgical resection is not possible. Would you recommend metastasis direct therapy to the liver (i.e. SBRT or...

What treatment would you recommend to a patient with a locally recurrent sarcoma of the retrohepatic IVC (reconstruction of IVC with PTFE graft) resected over 2 years ago?

This was resected over 2 years ago with reconstruction of the IVC with a PTFE graft. No preop or postop RT given and the recurrence is in the area whe...

What constraints do you use for a non-weight bearing bone when treating a patient with sarcoma?

Do you offer adjuvant radiation therapy for sacral chordoma s/p gross total resection with close margins <0.5 cm?

What dose would you use? For negative margins do you offer 50-50.4 Gy/25-28 fractions? What target volume margins do you typically recommend on t...

Would you offer upfront radiation for a large painful keloid of the chest that has arisen from an irritated pyoderma gangrenosum lesion?

What dose and fractionation do you recommend for an unresectable epithelioid hemangioendothelioma of the rib?

What radiation fractionation scheme would you use to palliate a patient with metastatic paratesticular leiomyosarcoma limited mainly to soft-tissue sites as well as the scrotum?

This patient is young and active but refuses palliative chemotherapy

When do you recommend post-operative radiation therapy for extracranial chondrosarcoma?

Is there a role for pre-operative RT?

In a patient with solitary metastasis skin/subcutaneous wrist, resected with graft, from a primary breast angiosarcoma, what would be your preferred fields and dose?

50+ yo F. Mastectomy, chemo, and RT in 2016 for primary breast angiosarcoma, not RT induced. Had longstanding cyst on wrist, biopsied, and positive fo...

When would you consider neoadjuvant RT for dermatofibrosacroma protuberans?

How would you manage a patient with epithelioid hemangioendothelioma?

How do you manage recurrent inoperable chest wall pleomorphic liposarcoma with prior radiation therapy?

Prior treatment: GTR in 2020, adjuvant radiation 63Gy Patient factors: Medically inoperable and not fit for chemotherapy The recurrence is within th...

What dose-fractionation and clinical target volume do you use when treating tenosynovial giant cell tumor (TGCT), historically known as pigmented villonodular synovitis (PVNS), of the knee?

What is your preferred regimen for palliative treatment of unresectable retroperitoneal sarcoma?

How would you manage a high grade primary mediastinal leiomyosarcoma status-post excision with negative margins?

What is the role for post-operative irradiation?

Do you recommend adjuvant RT for positive margins of dermatofibrosarcoma protuberans?

Would you change your management based on location, such as a sensitive area like the groin? What volumes do you recommend? Does age influence y...

Would you offer preoperative radiation for an intrathoracic leiomyosarcoma in the posterior mediastinum?

What dose and fractionation would you recommend for palliative-intent radiation therapy for cutaneous angiosarcoma in a patient with distant metastases?

Would you go beyond a traditional palliative regimen such as 30Gy in 10 fractions?

For post-operative radiation of resected high grade soft tissue sarcoma, how long of a delay do you tolerate before starting radiation?

This is particularly relevant for patients with extensive delays due to wound healing issues.

What is the clinical benefit of primary site postoperative radiation after neoadjuvant chemotherapy and oncologic surgery for an extremity soft tissue synovial sarcoma in an oligometastatic patient with pulmonary metastases ?

The pulmonary metastases are planned to be addressed with a combination of surgical resection and SBRT.

How do you manage near-field recurrence of a soft tissue sarcoma that was previously treated with pre-op RT?

Would you off more radiation if the prior pre-op radiation was within a few cm to the recurrence? If there a time interval you would wait before offer...

Would differentiating between embryonal vs alveolar rhabdomyosarcoma of the nasal cavity change your neoadjuvant chemotherapy regimen or make you consider neoadjuvant radiation in a locally advanced pleomorphic RMS?

40 yo adult patient with a~6cm mass with concern for skull base bony involvement (group III and stage III, no nodal involvement )

What is your approach to extremity STS (G2-3) after an initial unplanned (non-oncologic) surgery who is planned for oncologic re-excision?

When do you offer preop RT (50Gy) before the re-excision? When do you offer post-op RT after the re-excision?

Would you consider definitive radiation therapy (EBRT + interstitial HDR) in lieu of pelvic exenteration for a vaginal spindle cell sarcoma?

How would you treat unresectable angiosarcoma of the extremity in a patient who is inoperable due to underlying comorbidities?

How would you approach unresectable synovial sarcoma of the heart ?

When do you offer adjuvant radiation therapy for high grade non-rhabdomyosarcoma soft tissue sarcoma (NRSTS) in a skeletally mature teenager or young adult?

Individuals often cite ARST0332 to justify radiation omission in high grade R0 resections, but R0 was defined as > 5 mm margins.

Would you recommend prophylactic retro-peritoneal RT in an adolescent with paratesticular rhabdomyosarcoma, s/p radical inguinal orchiectomy without a lymph node dissection?

If a staging RPLND is NOT performed, is there a role for prophylactically irradiating the lymph nodes, even in the setting of a negative PET/CT at dia...

How would you approach an intrathoracic solitary fibrous tumor in a patient who is not a surgical candidate?

Would you consider SBRT?

How would you approach unresectable cutaneous angiosarcoma of the scalp?

What would be your radiation volumes/dose and choice of chemotherapy?

How would you approach subtotal resection of a sarcoma of the scrotum/groin with grossly positive margin at the base of the penis?

What adjuvant therapy would you recommend for a T3N0, grade 3, undifferentiated sarcoma of the mandible with positive margins that is not amenable to re-resection?

Would you offer adjuvant RT or chemotherapy? If so, what chemotherapy would you prefer?

Would you offer post-operative radiation therapy for a pseudoendocrine sarcoma with a CTNNB mutation of the spine that has been resected with a positive margin?

If so, what dose and treatment fields would you use?

How do you manage a soft tissue sarcoma arising from neurofibromas (NF1)?

Would you give adjuvant therapy after diagnosis of presumed stage IA, 5cm, ER/PR+ uterine adenosarcoma on a total hysterectomy with bilateral salpingoopheretomy without staging?

No sarcomatous overgrowth seen.

Would you consider boost radiation for focally positive margins after 50 Gy and surgery in undifferentiated pleomorphic sarcoma of chest wall?

Do you typically incorporate radiotherapy into the management of extraskeletal myxoid chondrosarcoma?

These tumors are often low grade, but have a propensity for local recurrence.

Would you offer neoadjuvant chemotherapy for a large, but recurrent grade 1-2 myxoid chondrosarcoma of knee which is no longer amenable to limb salvage?

Performance status is excellent. Second surgical opinion has also confirmed need for amputation, as the recurrence is now breaching intra and extra ar...

How would you treat osteosarcoma that has relapsed with unresectable pulmonary metastatic disease?

Would you offer adjuvant radiation for a grade 1 osteosarcoma of the mandilbe with close margins following surgical resection?

What margin would you consider to be necessary to omit radiation?

How would you manage a patient with isolated metastatic high grade sarcoma to inguinal and external nodes in a patient with BRCA+ mutation?

This patient had resection of the primary, requiring multiple resections to obtain an R0 resection, followed by adjuvant radiation to the primary. The...

Which adjuvant treatment(s) would you recommend for an incompletely resected, high grade osteoblastic osteosarcoma of the jaw?

Is chemoradiation a viable strategy in osteosarcoma?

For a patient with cardiac sarcoma, is there a minimum ejection fraction to proceed with adjuvant radiation therapy?

For cases of foraminal and extraforaminal monophasic synovial sarcoma post excision with note of residual tumor, would your approach be a second look surgery with re-excision or delivery of adjuvant RT with boost to residual disease?

Would you consider doing a pre-op RT prior to possible re-excision? If yes, what dose would you give? If the location is between L4-L5 spine.

When do you recommend preop RT for retroperitoneal sarcomas?

How do you interpret the results from the recently published EORTC-62092: STRASS study that showed no benefit to preop RT+surgery vs surgery alone and...

What is the appropriate dose/fractionation when treating a dermatofibrosarcoma protuberans of the spine following debulking surgery in a patient with a good performance status?

In this patient dermatofibrosarcoma protuberans of the thoracic spine, which originally caused a cord compression and has since been debulked, gross r...

What is your typical approach for soft tissue sarcomas of the buttock?

If post-op with clear margins would you prefer adjuvant RT or close observation with surgery for optimal reduction of local recurrence? This particula...

How would you incorporate whole abdomen radiation therapy after cytoreduction in an AYA patient with desmoplastic small round cell tumor?

What if the patient had also received HIPEC prior?

How would you manage a recurrent uterine leiomyosarcoma, now status post secondary cytoreduction, with no gross residual disease?

Would you consider adjuvant chemotherapy, radiation therapy, hormone therapy, or surveillance?

Would you offer adjuvant radiation to a patient with a vaginal spindle cell sarcoma s/p modified radical hysterectomy with bilateral sapingoopherectomy with negative margins?

Final pathology showed grade 3 spindle cell sarcoma of thee vagina involving the anterior lateral cervix 5.6cm x 4.5 x 3.4cm, <0.1cm left lateral m...

How would you modify adjuvant radiation for oral cavity SCC based on the presence of sarcomatoid features?

How would you approach therapy for a solitary fibrous tumor of the orbit with residual disease (10%) after surgery?

Which Radiation modality, if any, would be preferred? Typical chemotherapy does not work for SFT. In which circumstance would you use VEGF ( Temozolo...

How would you treat recurrent unresectable sarcoma in previously irradiated maxillary region, with no distant metastatic disease?

Would you offer preoperative radiation therapy when treating retroperitoneal sarcomas?

Recent results from the STRASS trial suggest limited benefit from preoperative radiation therapy for retroperitoneal sarcomas. https://pubmed.n...

How would you approach therapy in a young adult with synovial sarcoma of the head and neck who is not amenable to surgery due to location on the face?

Do you recommend salvage radiation therapy to limited recurrent Ewing's sarcoma bony lesions?

If you do what dose and fractionation do you recommend?

How would you approach therapy for a young, fit patient with alveolar rhabdomyosarcoma involving the anterior nasal vault/sinuses in the absence of available clinical trials?

Presented with mass projecting into right/left anterior ethmoid complex

What region would you treat in a patient with high grade leiomyosarcoma localized to the spermatic cord with close margins (<1mm) s/p inguinal orchiectomy?

More specifically there is no testicular invasion - would you cover the entire scrotal sac? What lymph node stations if any would you cover?

Would you recommend pre-op radiation for an operable recurrent well differentiated retroperitoneal liposarcoma with abutment of the right kidney?

The interval since prior resection is between 3-5 years. Additionally, there is some evidence of nodal involvement but no evidence of metastatic disea...

Would you give full post-operative dose radiation for an undifferentiated high grade pleomorphic sarcoma of the extremity with close surgical margins if the patient had previously received <20Gy preoperatively?

Re-excision would result in amputation. And the patient had attempted pre-operative RT but quit at 16Gy due to toxicity/social reasons. Would you trea...

Would you offer adjuvant chemotherapy for a large, high-grade radiation-induced malignant peripheral nerve sheath tumor following R1 resection?

>5cm. If so, what is your preferred regimen?

What CTV expansion volumes would you recommend for a large, unresectable, symptomatic desmoid tumor of the neck?

Would you use general sarcoma expansions or would smaller expansions like the ones in head and neck would be reasonable?

Would you consider preoperative radiation for a retroperitoneal sarcoma in a patient with Li Fraumeni syndrome where upfront surgery is likely to yield a positive margin?

Would chemotherapy be a consideration? If yes, would you adjust margins or dose?

In the setting of unresectable Ewing's sarcoma in an adult, would you consider boosting to a higher dose?

Specifically, when treating a tumor located in the head and neck region, would you consider treating closer to 64-66 Gy? Or would you be consistent wi...

Would you treat a pleomorphic sarcoma of the pelvis post-operatively?

When deciding to treat what would be your dose/volumes? And would a re-staging scan play a role in your treatment planning?

What do you consider a curative radiation dose for a sarcoma?

If a patient with a high grade sarcoma has gross residual/recurrent disease after resection and cannot undergo further surgery - would you boost this ...

5 Answers available

Are there any hypofractionated RT regimens that could be considered in a post-op setting for extremity soft tissue sarcoma?

What is your regimen? And long-term follow-up in these patients?

How would you approach a supraclavicular high grade monophonic synovial sarcoma?

What if it was status post partial resection? And had bilateral level 2 lymph nodes?

How are you modifying your current sarcoma-directed therapy in the setting of the COVID-19 pandemic?

For example, would you consider switching to an outpatient regimen in lieu of AIM for metastatic soft tissue sarcoma?

How do you treat plantar fibromatosis with radiation?

What dose schedule would you use to treat plantar fibromatosis? How soon after resection would you begin treatment? And how happy were you with the re...

What intracavitary brachytherapy regimen would you use after EBRT for a 4cm vaginal leiomyosarcoma the mid vagina with positive margins?

MRI with intravaginal gel shows no gross residual disease.

What radiation dose is appropriate for unresectable spindle cell sarcoma of the spine?

The case in question is a radiation-induced spindle cell sarcoma at the thoracic spine previously treated for a plasmacytoma to a dose of 60 Gy in 30 ...

In the setting of a recurrent Grade 1 liposarcoma of the spermatic cord that extended to the scrotum and was previously treated with surgery alone, what volume and dose would you use in following re-resection?

For both the primary and re-resection surgeries, resection was achieved via both scrotal and inguinal incisions. And margins were reported as negative...

Is there a maximum time delay in offering adjuvant radiation to patients with wound healing issues for sarcoma and skin cancer patients with aggressive histology and positive margins?

Sometimes wound healing can delay adjuvant radiotherapy by several months. For aggressive histology, such as high grade sarcomas or skin cancers with&...

Would you offer adjuvant radiotherapy for a malignant fibromyxoid tumor of soft tissue with margin < 1 cm on re-excision?

Adverse features include increased nuclear size, nuclear atypia, and mitotic activity up to 10/50 HPF.

How do you approach G-CSF use when offering neoadjuvant chemoRT for lower extremity soft-tissue sarcoma?

i.e. doxorubicin, ifosfamide + RT. Do you worry about decreased locoregional control or increased toxicities with the use of G-CSF in combination with...

Would you offer adjuvant radiation to a patient with uterine undifferentiated sarcoma s/p resection, vaginal cuff recurrence, and re-resection?

If so, would you treat the whole pelvis, cuff brachytherapy, or both?

How would you approach local recurrence of scalp angiosarcoma during the course of adjuvant radiotherapy after a widely R0 resection?

Recurrence is in the radiation field right at the border of graft and scalp, and started to surface at about 20-24 Gy. It is visibly enlarging over se...

What is the role of postoperative radiation therapy after complete resection of a high grade spermatic cord sarcoma?

68 y.o. Male underwent inguinal orchiectomy and spermatic cord resection of a 5 cm malignant fibrous histiocytoma of the spermatic cord. Margins of re...

How would you suggest to radiate a Kaposi's sarcoma?

Would certain patient/disease characteristics make you choose RT therapy over chemotherapy or other locally ablative therapies? What dose/fraction wou...

5 Answers available

Are there any types of sarcomas that you use induction and/or concurrent chemotherapy with radiation prior to surgery?

Specifically concurrent ifosfamide? Induction AIM?

How do you define close and negative margins for soft tissue sarcoma?

Did the publication earlier this year by Gundle et al. JCO 2018 (http://ascopubs.org/doi/pdf/10.1200/JCO.2017.74.6941) alter your concept of close mar...

Do you offer adjuvant radiation therapy for a patient with a > 5 cm resected malignant peripheral nerve sheath tumor with 1 cm negative margin?

What margins (if any) do you consider appropriate to not require adj RT? And would you ever consider neoadj RT?

Are there any anatomical locations that you would consider omiting preoperative radiation for sarcoma due to toxicity concerns?

Specifically the groin region? Or are there techniques or a change in the management style of radiation at these sites you would employ to minimize to...

Do you routinely offer post-operative radiotherapy for resected retroperitoneal sarcomas?

If so, how do you choose your region of treatment? Dose? And elective nodal volume?

Is postoperative radiotherapy indicated for a 5 cm grade 2 synovial sarcoma of the knee joint?

If margins are clear, would this tumor necessitate adjuvant radiotherapy? Synovial sarcomas often occur in a young patient subset, would this cause yo...

Do you treat retroperitoneal sarcomas with a boost to the rind (or suspected close surgical margin)?

If so, what patients do you select for the boost? And what data do you give to adequately satisfy the insurance review and win approval?

Is there a benefit to EBRT for recurrent solitary fibrous tumor/ hemangiopericytoma in patient with multiple sites of intrapelvic recurrence?

In a patient, with multiple small volume lesions (5-25mm), would you offer pelvic RT?

How would you manage a recurrent chest wall desmoid tumor?

After and extensive en bloc resection, is there further surgery that would be recommended? Is radiation alone sufficient?

How do you manage sarcomas of the hand or the feet?

Would you treat these sites to definitive or post-operative doses? If not, is there a dose constraint you use at these sites? Do you use tighter margi...

How would you manage an osteosarcoma patient with local disease only and an R0 resection who could not tolerate neoadjuvant chemotherapy?

Is there a role for adjuvant radiation? Other chemotherapy options?

How would you optimize patient set-up and planning for the post-operative treatment of a distal lower extremity sarcoma?

What things would you take into consideration for the simulation set-up? Specific instructions for treatment planning? If the PTV is confined to only ...

In the setting of an atypical lipoma/well-differentiated liposarcoma of the extremity with a small component of dedifferentiated liposarcoma, is it necessary to treat the entire mass with neoadjuvant radiotherapy OR just the dedifferentiated component that is enhancing on contrast MRI?

How would you treat a high grade sarcoma of the breast?

Is breast conserving surgery followed by radiation therapy an option?

Would you consider SBRT for a retroperitoneal sarcoma with an R2 resection near critical structures precluding re-resection?

What would your RT volumes be for a high grade sarcoma of a joint (such as the knee) after a gross total resection?

How do you treat pleomorphic rhabdomyosarcoma in an adult?

Do you follow pediatric protocols or treat this more like a high grade soft tissue sarcoma? Specifically for paratesticular pleomorphic RMS, do you ad...

What are the recommended treatment fields for desmoid tumors?

Is a margin of 5 cm on the GTV still standart?

What evidence is there for the benefit of adjuvant radiation therapy for a large primary thoracic synovial sarcoma that was completely resected?

What are some guidelines or principles that you use to recommend adjuvant radiation after complete resections of sarcoma?

How do you define your post-operative treatment volumes for a patient with a resected high-grade soft tissue sarcoma of the soft tissues of the upper back?

For example, in the setting of a lack of pre-operative imaging, what CTV margin(s) would you utilize for the initial and boost phases of treatment?

Do you treat radiation-induced sarcomas similarly to de novo sarcomas?

How does grade, margin status, and previous radiation dose factor into the recommendation?

What are your indications for treating a pelvic desmoid tumor in a young woman concerned with fertility?

When do you consider is too late after resection to offer adjuvant therapy for high grade osteosarcoma?

What time delay would make the benefit of adjuvant therapy likely no longer significant?

Do you recommend imaging surveillance vs adjuvant RT for a large low grade sarcoma of the lower extremity with multiple positive margins?

Would it differ if the tumor was high grade at the same location?

What is your treatment approach to patients with extremity sarcoma with multiple positive regional nodes?

Do you offer neoadjuvant RT with resection and node dissection vs. definitive radiation? How extensive does the nodal disease have to be for you...

How do you manage an adult primary rhabdomyosarcoma of the lung/mediastinum?

Is there any role for consolidative RT/CRT to the lung and mediastinum after initial chemo? What dose and fractionation would be most appropriate for ...

Would you recommend adjuvant radiation for a completely resected large well differentiated sarcoma (i.e. liposarcoma) involving the retropharyngeal area and mediastinum?

Should such a case be treated like retroperitoneal sarcoma?

Do you routinely treat postoperative extremity soft tissue sarcoma with IMRT?

If so, how to you address the scar? Do you use bolus? Do you place a 2mm retraction from skin for the target contour?

For retroperitoneal sarcomas, do you consider neoadjuvantly boosting the "posterior rind" or area at high risk of positive margin?

If so, to what dose?

What treatment fields and dose do you use in the treatment of postoperative angiosarcoma of the scalp?

With the high rates of recurrence postoperatively with angiosarcomas of the scalp, adjuvant radiation is often recommended. What margins would y...

When pre-operatively treating high grade soft-tissue sarcomas involving the chest, abdomen, or pelvis what margins do you use for CTV and PTV?

Most guidelines discuss target delineation and contouring recommendations for extremity sarcomas, which generally suggest larger longitudinal than rad...

In what settings would you offer adjuvant radiation for a R1 resected desmoid tumor?

Do you routinely boost focally positive margins after preoperative 50 Gy and surgery in patients with extremity sarcomas?

For example, a patient with liposarcoma of the lower extremity status post preoperative radiation to 50 Gy who then underwent resection and had focall...

Do you boost residual lung disease after chemotherapy after whole lung irradiation for patients with Ewings, Rhabdomyosarcoma or Wilms?

Can you use SBRT for boost?

What dose should be used for a G3 retroperitoneal sarcoma with R1 resection?

Would the dose change based if there was tumor adherent to bowel versus abdominal wall or muscle?

What dose would be appropriate for large intra-abdominal or retroperitoneal sarcomas that are unresectable?

Would the histological grade or histology affect the dose? Would you consider dose escalating to the center of the tumor if this would not affect orga...

When treating a patient with a high grade sarcoma in the post op setting, do I need to get full dose to the incision and drain site (assuming all margins negative)?

When treating a soft tissue sarcoma close to humeral head, what humeral head dose constraint should be used?

I am treating a resected high grade liposarcoma with positive surgical margins to 66Gy. I would prefer to use IMRT to spare the humerus, but ...

For extremity rhabdomyosarcomas (hand) with positive epitrochlear and axillary lymph nodes, do you treat the lymph nodes or just the primary?

What is the risk of joint issues if you treat the epitrochlear nodes?

What dose do you feel comfortable treating the entire circumference of an extremity to before you are concerned about chronic toxicity?

When the disease (in this case, lymphoma) involves almost all of the entire muscle compartment of the distal lower extremity, what is a safe dose? I'm...

What dose do you use in the adjuvant treatment of desmoid tumors?

And does your dose changes with positive margins? I can't seem to find a good answer in the literature.