Abstract
Local control cannot be achieved in many cases of soft tissue sarcoma by surgery alone. Additional irradiation is often necessary. This reveals the question of the optimal sequence of resection, reconstruction and irradiation.
Material: We present
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A review of the literature concerning preop and postop irradiation in soft tissue sarcoma.
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The criteria of decision making in 15 cases of our own patients concerning the question of preop and postop irratdiation.
Results:
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Review of the literature: There ist a certain benefit in additional irradiation concerning local control, but there is no evidence in favour of preop or postop irradiation concerning overall survival.
Clinical cases:
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Preop irradiation is preferred in all cases of microvascular bone repair in order not to interfere with bony healing and hypertrophy of the transplants.
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Pathological fractures after irradiation are very difficult to treat.
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In children irradiation has to respect the epiphyseal areas.
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Microvascular tissue transfer after irradiation may fill up big tissue defects after wide resection, may improve wound healing and prevent lymph edema
Correspondence should be addressed to Professor Stefan Bielack, Olgahospital, Klinikum Stuttgart, Bismarkstrasse 8, D-70176 Stuttgart, Germany. Email: s.bielack@klinikum_stuttgart.de
