Do you offer neoadjuvant radiation therapy for oral cavity sarcoma?

Rare situation. Be sure the path is unequivocal (and not e.g., a sarcomatoid SCC, which is not at all a sarcoma). If it really is a sarcoma, preop (50 Gy/25 fx with sarcoma expansions) is reasonable if your surgeon is comfortable with it, but oftentimes there is less familiarity/comfort with preop RT in the ENT world. This is also a location where you can get in 60-66 Gy postop just the same as you would for HNSCC, so postop is reasonable as well (and would give you further path confirmation before treating). If large, also see med onc to think about neoadj chemo. @Dr. First Last reported some years ago on Toronto’s experience with preop RT for HN STS and an update was presented recently as well at ASTRO: O'Sullivan et al., PMID 14509522.

This is where a multidisciplinary tumor board can be helpful because you want to make sure your H&N surgeons are comfortable with operating after radiation before proceeding down that route. Since pre-op RT is done so infrequently for H&N cancers, some ENTs may not want to try it.

Surgery and postop RT if suitable for a gross total resection.