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Cancers
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Radiotherapy for Sarcoma
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Radiotherapy for Sarcoma

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 15 March 2026 | Viewed by 1734

Special Issue Editors

Dr. Safia K. Ahmed

E-Mail Website
Guest Editor
Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ, USA
Interests: soft tissue sarcoma; bone sarcoma; breast cancer; pediatric malignancies; proton therapy
Dr. Miranda Lam

E-Mail Website
Guest Editor
1. Department of Radiation Oncology, Brigham and Women’s Hospital, Boston, MA, USA
2. Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
Interests: gastrointestinal malignancies; sarcoma

Special Issue Information

Dear Colleagues,

This Special Issue focuses on the role of radiation oncology in the management of soft tissue and bone sarcomas. We aim to highlight the pivotal contributions of radiation therapy in both curative and palliative settings for these rare and challenging malignancies, particularly in light of groundbreaking recent advances. This issue will compile clinical experiences, insights into tumor biology, cutting-edge research, and innovative treatment strategies designed to improve patient outcomes. Key topics include the role of radiation therapy within a multidisciplinary treatment framework, technical advancements, optimal dose and fractionation schemes, treatment timing and delivery strategies, the management of outcomes and toxicity, and future research directions. We welcome submissions that align with these topics and contribute to a deeper understanding of the current and future landscape of radiation therapy for sarcoma.

Dr. Safia K. Ahmed
Dr. Miranda Lam
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • soft tissue sarcoma
  • bone sarcoma
  • advanced sarcoma
  • radiation therapy
  • particle therapy
  • multidisciplinary sarcoma care

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Published Papers (3 papers)

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Research

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13 pages, 1190 KB  
Article
Carbon Ion Radiotherapy for Retroperitoneal Sarcoma: A Single-Institution Study
by Reiko Imai, Tsukasa Yonemoto, Nobuhito Araki, Hirotoshi Takiyama, Hiroaki Ikawa, Shigeru Yamada and Hitoshi Ishikawa
Cancers 2025, 17(20), 3395; https://doi.org/10.3390/cancers17203395 - 21 Oct 2025
Viewed by 168
Abstract
Background/Objectives: Surgery remains the mainstay of treatment for retroperitoneal sarcoma (RPS); however, definitive therapeutic strategies for patients with insufficient surgical margins and unresectable disease owing to locally advanced RPS remain unclear. Carbon ion radiotherapy (CIRT) has been employed in patients with unresectable RPS. [...] Read more.
Background/Objectives: Surgery remains the mainstay of treatment for retroperitoneal sarcoma (RPS); however, definitive therapeutic strategies for patients with insufficient surgical margins and unresectable disease owing to locally advanced RPS remain unclear. Carbon ion radiotherapy (CIRT) has been employed in patients with unresectable RPS. This study aimed to evaluate the effectiveness of CIRT in this patient population. Methods: A retrospective analysis was conducted in 76 patients with unresectable RPS treated with CIRT. Of these, 95% had a confirmed prognosis until 2022. In 74 patients, the prescribed relative biological effectiveness dose was 70.4 Gy, delivered in 16 fractions over 4 weeks. Respiratory gating was used, and spot scanning irradiation has been performed in all patients since 2016. Results: The 3- and 5-year overall survival rates for the entire cohort were 68.3% and 49.4%, respectively, with a median overall survival time of 58.1 months. The 3- and 5-year local control rates were 79.0% and 72.0%, respectively. Among 47 naïve patients with treatment-naïve tumors, the 3- and 5-year abdominal recurrence-free survival rates were 51.1% and 29.1%, respectively. Late adverse events of grade 3 or higher occurred in 4 (5.2%) patients. Conclusions: CIRT represents a definitive treatment option for patients with unresectable RPS. In the future, multicenter studies should be conducted to evaluate the effectiveness of CIRT for RPS in larger patient cohorts. Full article
(This article belongs to the Special Issue Radiotherapy for Sarcoma)
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24 pages, 4173 KB  
Article
The Effect of Lurbinectedin as a Monotherapy and in Combination with Ionizing Radiation on Sarcoma Cell Lines
by Hannah Alsheimer, Paula Schiller, Sabine Semrau, Felix Grabenbauer, Rainer Fietkau, Luitpold V. Distel and Laura S. Hildebrand
Cancers 2025, 17(17), 2930; https://doi.org/10.3390/cancers17172930 - 7 Sep 2025
Viewed by 1003
Abstract
Background/Objectives: Soft tissue sarcomas are rare, heterogeneous tumors with limited therapeutic options and suboptimal outcomes in advanced stages. Lurbinectedin is a promising new antineoplastic alkylating agent. This study investigates its cytotoxic effects and its potential as a radiosensitizing agent on soft tissue sarcoma. [...] Read more.
Background/Objectives: Soft tissue sarcomas are rare, heterogeneous tumors with limited therapeutic options and suboptimal outcomes in advanced stages. Lurbinectedin is a promising new antineoplastic alkylating agent. This study investigates its cytotoxic effects and its potential as a radiosensitizing agent on soft tissue sarcoma. Methods: Four soft tissue sarcoma cell lines were treated with lurbinectedin alone or in combination with ionizing radiation. Single-dose irradiation in a 4-day protocol was compared with prolonged treatment and an additional fractionated ionizing radiation scheme in a 6-day protocol. Cellular responses were analyzed by flow cytometry for apoptosis (Annexin V)/necrosis (7AAD) and cell cycle (Hoechst), clonogenic cell survival, and scratch assays for cell migration. Results: In the 4-day protocol, lurbinectedin induced G2/M arrest in all cell lines (p = 0.029) and significantly increased apoptosis/necrosis (p = 0.029) in SW-872. Lurbinectedin-treatment resulted in a decrease (p ≤ 0.002) of clonogenic cells in all cell lines. In the scratch assay, cell migration was delayed in two cell lines (p = 0.048) after lurbinectedin-treatment. Additional radiotherapy had no significant effect compared to lurbinectedin-monotherapy in apoptosis/necrosis and G/2M arrest in the 4-day protocol, clonogenic cell assay, and scratch assay. In the 6-day protocol, lurbinectedin induced an increase (p = 0.029) in G2/M arrest in all cell lines and apoptosis/necrosis in three cell lines, while resulting in a decrease (p < 0.001) of clonogenic cells. Additional radiotherapy had a significant effect on the decrease in clonogenic cells (p ≤ 0.048) in two cell lines but did not increase G2/M arrest and apoptosis/necrosis. Conclusions: Lurbinectedin had strong effects on three of the selected cell lines by inducing G2/M arrest, promoting apoptosis/necrosis, and reducing clonogenic survival, suggesting that it may be a promising chemotherapeutic agent in soft tissue sarcoma treatment. The effect on the fourth cell line was limited, as well as the effect on cell migration. Single-dose irradiation occasionally interfered with the effects of Lurbinectedin, whereas adding fractionated irradiation caused an additional decrease in clonogenic survival, indicating that the combination of Lurbinectedin with fractionated ionizing radiation may have promising effects. Full article
(This article belongs to the Special Issue Radiotherapy for Sarcoma)
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Review

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19 pages, 1273 KB  
Review
Proton Beam Therapy and the AYA Sarcoma Patient Journey: Highlighting Needs from Diagnosis to Survivorship
by Margaret M. Harris and Safia K. Ahmed
Cancers 2025, 17(21), 3402; https://doi.org/10.3390/cancers17213402 - 22 Oct 2025
Viewed by 77
Abstract
Background: Adolescents and young adults (15–39 years of age at time of diagnosis: AYA) with sarcoma are a unique patient population. The objective of this review is to examine the literature outlining the benefits of proton beam therapy (PBT) for treatment of [...] Read more.
Background: Adolescents and young adults (15–39 years of age at time of diagnosis: AYA) with sarcoma are a unique patient population. The objective of this review is to examine the literature outlining the benefits of proton beam therapy (PBT) for treatment of AYA sarcoma patients, barriers to PBT, evaluation of AYA-specific considerations and challenges, and exploration of future opportunities for improvements in care. Methods: An electronic search was conducted using databases and online search engines, primarily PubMed. The search criteria included studies and reviews completed from 2015 to 2025. Results: 57 articles were reviewed and categorized into sections: PBT for the treatment of the AYA patient, barriers to PBT, AYA-specific considerations and challenges, and future directions for the care of an AYA patient. Conclusions: Through this review, PBT can be deemed necessary when treating AYA sarcoma patients with radiation therapy to decrease long-term therapy-related toxicities. Furthermore, considerations for caring for an AYA sarcoma patient must extend beyond evidence-based treatment plans and must embrace the patient as a whole person through acknowledgement of the challenging impact on physical, mental, and social well-being from symptoms to diagnosis, diagnosis to treatment, and treatment to survivorship. Full article
(This article belongs to the Special Issue Radiotherapy for Sarcoma)
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