Neoadjuvant Radiotherapy-Related Wound Morbidity in Soft Tissue Sarcoma: Perspectives for Radioprotective Agents

• Main Authors: Cameron M. Callaghan, M. M. Hasibuzzaman, Samuel N. Rodman, Jessica E. Goetz, Kranti A. Mapuskar, Michael S. Petronek, Emily J. Steinbach, Benjamin J. Miller, Casey F. Pulliam, Mitchell C. Coleman, Varun V. Monga, Mohammed M. Milhem, Douglas R. Spitz, Bryan G. Allen
• Format: Article
• Language: English
• Published: MDPI AG 2020-08-01
• Series: Cancers
• Subjects: wound healing; soft tissue sarcoma; radiotherapy complications; radioprotective agents; neoadjuvant radiotherapy; limb preservation
• Online Access: https://www.mdpi.com/2072-6694/12/8/2258

Historically, patients with localized soft tissue sarcomas (STS) of the extremities would undergo limb amputation. It was subsequently determined that the addition of radiation therapy (RT) delivered prior to (neoadjuvant) or after (adjuvant) a limb-sparing surgical resection yielded equivalent survival outcomes to amputation in appropriate patients. Generally, neoadjuvant radiation offers decreased volume and dose of high-intensity radiation to normal tissue and increased chance of achieving negative surgical margins—but also increases wound healing complications when compared to adjuvant radiotherapy. This review elaborates on the current neoadjuvant/adjuvant RT approaches, wound healing complications in STS, and the potential application of novel radioprotective agents to minimize radiation-induced normal tissue toxicity.