Childhood Soft Tissue Sarcoma Treatment

If your child receives a soft tissue sarcoma diagnosis, the doctor will talk to you about the best ways to treat it. This depends on several things, including:

• The location and type of sarcoma
• If the cancer has spread
• Your child's age and health

Your child's treatment for soft tissue sarcoma will be customized and carefully planned. It may include one or more of the following.

Surgery

The main treatment for soft tissue sarcoma is surgery. If the entire tumor can be removed, successful treatment is more likely.

During the operation, the surgeon removes the tumor and some tissue around it to take out as many cancer cells as possible. Lymph nodes may be removed too to check for the spread of cancer.

Your child may receive chemotherapy or radiation therapy before or after the surgery.

Because of a special type of procedure called limb-sparing surgery, which is often followed by radiation therapy, most patients do not have to have arms or legs amputated to treat sarcoma.

Learn more about surgery.

Chemotherapy

Chemotherapy drugs kill cancer cells, control their growth or relieve disease-related symptoms. Chemotherapy may involve a single drug or a combination of two or more drugs, depending on the type of cancer and how fast it is growing.

Patients can receive chemotherapy through pills, injections or intravenous (IV) infusion. If the patient is receiving intravenous chemotherapy, sessions usually take several hours, depending on the drugs being used. Most chemotherapy treatments for childhood soft tissue sarcoma are given in cycles over several months, with treatment typically repeated every two to three weeks.

The side effects of chemotherapy depend on the exact drug the patient receives. They can include hair loss, nausea, fatigue and an increased risk of infection.

Chemotherapy may be given before surgery to shrink the tumor and make it easier to remove during surgery. In certain types of soft tissue sarcoma, or if the cancer has spread, chemotherapy may be given after surgery.

Learn more about chemotherapy.

Targeted therapies

Targeted therapy drugs are designed to stop or slow the growth or spread of cancer. This happens on a cellular level. Cancer cells need specific molecules (often in the form of proteins) to survive, multiply and spread. These molecules are usually made by the genes that cause cancer, as well as the cells themselves. Targeted therapies are designed to interfere with, or target, these molecules or the cancer-causing genes that create them.

Patients can receive targeted therapy through pills, injections or intravenous (IV) infusions, depending on the drug. If the patient is receiving intravenous targeted therapy, sessions usually take about 30 minutes to several hours. Most targeted therapy treatments for childhood soft tissue sarcoma are given daily or in repeating treatment cycles over several months, depending on the specific drug and treatment plan.

The side effects of targeted therapy depend on the exact drug the patient receives. They can include fatigue, nausea, diarrhea, skin rash, high blood pressure and an increased risk of infection.

Learn more about targeted therapies.

Radiation therapy

Radiation therapy uses powerful, focused beams of energy to kill cancer cells. There are several different radiation therapy techniques. Doctors can use these to accurately target a tumor while minimizing damage to healthy tissue.

Although radiation therapy is rarely the main treatment for soft tissue sarcoma, it may be used before surgery to shrink the tumor or after surgery to eliminate remaining cancer cells. However, it can be used if the tumor cannot be removed by surgery. It can also be utilized for disease that has spread, or palliatively for pain control or other symptoms. Radiation treatments include:

• 3D conformal radiation therapy: Uses three-dimensional imaging scans to determine the exact shape and size of the tumor. Radiation beams are then shaped using small metal leaves inside the treatment machine so the radiation closely matches the tumor’s dimensions.
• Intensity modulated radiation therapy (IMRT): Delivers multiple radiation beams of varying intensities that are carefully shaped and directed at the tumor to deliver a high dose of radiation while reducing exposure to surrounding tissue.

Learn more about radiation therapy.

Proton therapy

Proton therapy is a type of radiation therapy. It is similar to standard radiation therapy, but it uses a different type of energy that may allow doctors to target tumors with much greater accuracy. This limits damage to nearby healthy tissue and allows for the delivery of a more powerful dose of radiation.

Childhood soft tissue sarcoma patients receiving proton therapy usually undergo one treatment per day, five days a week, for about five to six weeks, depending on the tumor type and treatment plan. Sessions usually last about 30 to 60 minutes, although the radiation itself is delivered in just a few minutes.

Side effects of proton therapy are usually milder than with some traditional radiation treatments, though they vary depending on the tumor’s location and the dose delivered. Common side effects may include fatigue, skin irritation in the treated area and temporary swelling or soreness near the treatment site.

The Proton Therapy Center at UT MD Anderson is one of the largest and most advanced centers in the world. It's the only proton therapy facility in the country located within a comprehensive cancer center. This means that this cutting-edge therapy is backed by all the expertise and compassionate care for which UT MD Anderson is famous.

Learn more about proton therapy.

Active surveillance (Watchful waiting)

In some cases, the best approach may be to monitor the tumor closely before starting treatment. During active surveillance, your child’s doctor will carefully watch the condition with regular checkups, imaging tests and other evaluations.

This approach may be recommended if the tumor is slow growing, causing few or no symptoms, or if immediate treatment is not necessary. If tests show that the tumor is growing or beginning to cause problems, treatment might begin right away.

What to expect during childhood soft tissue sarcoma treatment

Treatment for childhood soft tissue sarcoma is personalized and may involve multiple therapies. Families can expect:

• Appointments and procedures: Multiple visits with oncologists, surgeons and supportive care providers; some procedures may require short hospital stays.
• Side effects and symptom management: Chemotherapy may cause fatigue, nausea, or hair loss. Radiation, including proton therapy, can irritate the skin or cause temporary swelling. Your care team will provide strategies to manage side effects.
• Rehabilitation and supportive care: Physical, occupational or speech therapy may help restore function. Emotional support is available for your child and family.
• Daily life and school: Some activities may need adjustment. Schools can help with accommodations and catching up on missed work.
• Monitoring and follow-up: Regular exams and imaging help track your child’s progress and detect any recurrence early.
• Family involvement: Families play a key role in care, including medication management, exercises at home and communicating with the care team.

Learn more about childhood soft tissue sarcoma:

• Childhood soft tissue sarcoma overview
• Childhood soft tissue sarcoma symptoms
• Childhood soft tissue sarcoma diagnosis