NCCN Guidelines for Patients
Soft Tissue Sarcoma, Version 1.2014
maps the treatment options for
stages II and III that can’t be treated with surgery
at first. However, other treatments may shrink
the tumor so that surgery can be done. These
treatments include radiation therapy, chemoradiation,
chemotherapy, or isolated limb chemotherapy.
Isolated limb chemotherapy only treats the limb with
sarcoma. The drugs are injected into blood vessels
within the limb. This prevents chemotherapy from
affecting the rest of your body.
After treatment, your doctors will assess if you are
able to have surgery with good results. Good results
include a surgical margin larger than 1 cm, cancer-free
margins, and good use of your limb or other body part.
If you have surgery, you may have radiation therapy
if you had none before. If you had radiation therapy
before surgery, you may receive a radiation boost.
You may or may not also have chemotherapy after
surgery. The research on its benefits at this point
of care is limited. It is not clear if chemotherapy
is helpful. Joining a clinical trial that is testing
chemotherapy may be a good option.
There are treatment options if you are unable to have
surgery. Amputation should be used as a last resort.
Your doctors will consider many factors to decide
which other options are best for you.
Some patients can have radiation therapy. The goal
is to cure the cancer. The highest dose that doesn’t
cause severe side effects is recommended. If you
will have EBRT, treatment planning should use IMRT,
tomography, or protons.
If you can’t have radiation therapy and you have
no symptoms from the cancer, you may undergo
observation. Observation is a period of regular testing
for cancer growth so treatment can be started if
Palliative care is recommended if the cancer is
causing symptoms. There are three options. You may
have chemotherapy, surgery, or best supportive care.
lists care after cancer treatment has
ended. You should receive rehabilitation if needed.
This may include occupational or physical therapy.
You should also start to have follow-up tests to check
if the cancer has returned. Getting follow-up tests
can help find cancer early. Cancer is more likely to
be cured if found early. Tests include medical history,
physical exam, and imaging of your chest. If the
cancer is likely to return, you may get imaging tests of
the site where the primary tumor was.
Sarcomas in limbs, outer trunk, head, or neck Stages II and III sarcoma