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| Home > Publications database > ESTRO clinical practice guideline on radiotherapy for adult soft tissue sarcoma of the extremities and trunk wall - Endorsed by ASTRO. |
| Home > Publications database > ESTRO clinical practice guideline on radiotherapy for adult soft tissue sarcoma of the extremities and trunk wall - Endorsed by ASTRO. |
| Journal Article | DKFZ-2026-00921 |
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2026
Elsevier Science
Amsterdam [u.a.]
Abstract: This updated clinical practice guideline provides a practical, evidence-based approach for the management of adult soft tissue sarcoma of the extremity and trunk wall.The European Society for Radiotherapy and Oncology (ESTRO) formed a task force of 13 European experts, alongside 3 experts from the American Society for Radiation Oncology (ASTRO), to analyze current evidence, give recommendations and establish expert consensus in areas lacking strong evidence. Thirteen key questions were identified, encompassing indications for radiotherapy, pre- vs. postoperative radiotherapy, treatment preparation, patient positioning, target volume delineation, dose and fractionation, adverse events assessment, and dose guidance for organs of interest. Key recommendations were formulated and tabulated for each topic, addressing all identified key questions.Recommendations for 13 key questions were developed. Dosing for certain subtypes or clinical scenarios has evolved. Despite advancements in imaging, radiotherapy techniques, and personalized approaches, the core principles of treatment planning remain consistent with established practices. Innovative approaches, such as preoperative hypofractionation, radiotherapy combined with systemic therapies (immunotherapy, targeted therapies), and further histotype-specific dose tailoring, show promise; however, they should not be integrated into routine practice until further evidence is obtained.Preoperative conventionally fractionated radiotherapy, delivered using highly conformal techniques and volumetric imaging, followed by surgery, remains the preferred sequencing strategy for localized soft tissue sarcoma. Multidisciplinary evaluation at expert sarcoma centers remains essential for determining the optimal treatment approach for each patient.
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