Onkologie. 2025:19(4):194-197 | DOI: 10.36290/xon.2025.036

Radiotherapy for soft tissue sarcomas of the head and neck

Tereza Drbohlavová

Radioterapeutické oddělení Ústavu radiační onkologie FNB a 1. LF UK a IPVZ, Praha

Head and neck soft tissue sarcomas (HNSTS) represent a rare group of mesenchymal tumors. Their histological heterogeneity, distinct biological behavior, and the anatomical complexity of the region make their management particularly challenging. Surgical resection remains the cornerstone of curative treatment; however, due to the frequent difficulty in achieving negative margins, radiotherapy (RT) is an essential component of multimodal therapy. Adjuvant RT improves local control (LC), especially in cases with positive or close margins. The neoadjuvant approach may offer advantages in terms of lower dose, smaller irradiated volumes, and reduced late toxicity, albeit at the cost of a slightly higher rate of postoperative complications. Data on the effectiveness of RT as a standalone treatment are limited. Most authors do not recommend routine elective nodal irradiation or neck dissection unless nodal involvement is confirmed. Target volume definition and dose prescription should be based on tumor location, histological subtype, resection margin status, and proximity to critical structures. Multidisciplinary collaboration and treatment in high-volume sarcoma centers are key to optimizing outcomes. This review aims to summarize current knowledge on the indications and implementation of RT in the management of HNSTS.

Keywords: soft tissue sarcomas, head and neck tumours, radiotherapy, target volumes.

Accepted: September 30, 2025; Published: October 8, 2025  Show citation