There is a misconception that sarcomas are resistant to radiotherapy. This manuscript summarizes available (pre-) clinical data on the radiosensitivity of soft tissue sarcomas. Currently, clinical practice guidelines suggest irradiating sarcomas in 1.8-2 Gy once daily fractions. Careful observation of myxoid liposarcomas patients during preoperative radiotherapy led to the discovery of this subtype's remarkable radiosensitivity. It resulted subsequently in an international prospective clinical trial demonstrating the safety of a reduced total dose, yet still delivered with conventional 1.8-2 Gy fractions. In several areas of oncology, especially for tumors of epithelial origin where radiotherapy plays a curative role, the concurrent application of systemic compounds aiming for radiosensitization has been incorporated into routine clinical practice. This approach has also been investigated in sarcomas and is summarized in this manuscript. Observing relatively low α/β ratios after preclinical cellular investigations, investigators have explored hypofractionation with daily doses ranging from 2.85-8.0 Gy per day in prospective clinical studies, and the data are presented. Finally, we summarize work with mouse models and genomic investigations to predict observed responses to radiotherapy in sarcoma patients. Taken together, these data indicate that sarcomas are not resistant to radiation therapy.

中文翻译：

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揭开软组织肉瘤抗辐射的神话

人们有一种误解，认为肉瘤对放射治疗有抵抗力。本手稿总结了有关软组织肉瘤放射敏感性的可用（前）临床数据。目前，临床实践指南建议每天一次以 1.8-2 Gy 的剂量照射肉瘤。在术前放疗过程中对粘液样脂肪肉瘤患者的仔细观察发现了这种亚型显着的放射敏感性。随后进行的一项国际前瞻性临床试验证明了减少总剂量的安全性，但仍采用传统的 1.8-2 Gy 剂量。在肿瘤学的几个领域，特别是对于放射治疗发挥治疗作用的上皮来源的肿瘤，同时应用旨在放射增敏的全身化合物已被纳入常规临床实践。这种方法也在肉瘤中进行了研究，并在本手稿中进行了总结。在临床前细胞研究后观察到相对较低的 α/β 比值，研究人员在前瞻性临床研究中探索了每日剂量范围为 2.85-8.0 Gy 的大分割，并提出了数据。最后，我们总结了小鼠模型和基因组研究的工作，以预测观察到的肉瘤患者对放射治疗的反应。综上所述，这些数据表明肉瘤对放射治疗没有抵抗力。