Computed tomography in therapy planning: Bone and soft tissue sarcomas

There are 1,900 new cases of primary bone sarcoma and 4,500 soft tissue sarcomas diagnosed annually in the United State, for a total of 6,400. This represents 0.9% of all malignant disease excluding carcinoma in situ and nonmelanoma skin cancers. Radiation therapy plays an important role in the management of a large proportion of patients with soft tissue sarcomas as well as some primary sarcomas of bone. Computed tomography (CT) provides unique cross-sectional anatomic detail of tumor boundaries as well as defining proximity to or invasion of adjacent normal structures. This information should result in more sophisticated treatment strategies, whether surgery, chemotherapy, and radiotherapy are used alone or in combination. When radiotherapy is utilized, it is essential that the treatment volume be no larger than necessary to cover tissues involved with gross and microscopic tumor. Utilization of CT information in treatment planning should help provide a greater chance for local tumor ablation coupled with the best possible functional and cosmetic results