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Cureus. 2017 Sep 15;9(9):e1687. doi: 10.7759/cureus.1687.

Excellent Pathologic Response and Atypical Clinical Course of High-Grade Extremity Sarcoma to Neoadjuvant Pencil Beam Scanning Proton Therapy.

Author information

Radiation Oncology, University of Maryland School of Medicine.
Department of Orthopaedics, University of Maryland School of Medicine.
Department of Pathology, University of Maryland Medical Center.


Neoadjuvant radiation therapy, followed by definitive surgical resection, remains the standard of care for resectable high-grade and unresectable soft tissue sarcomas. Proton therapy offers the promise of highly conformal dose distributions with improved sparing of neighboring normal tissues as compared with conformal and intensity modulated photon techniques. It is unclear whether proton therapy may offer an improved tumoral response, especially with dose escalation, in this relatively radio-insensitive tumor type. We, herein, present a patient with an excellent pathologic response to preoperative pencil beam scanning proton therapy despite a complex treatment course.


complete response; high grade sarcoma; igrt; image guidance; pbs; pencil beam scanning proton therapy; proton therapy; relative biological effectiveness; sarcoma; soft tissue sarcoma

Conflict of interest statement

The authors have declared that no competing interests exist.

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