1. Radiation therapy or not.
It is not like Olga knows the best, but rather there should be a proof that radiation given after the resection with the negative margins in ASPS increases the overall survival and the reduces the rate of the distant metastasis - which is the main cause of death in ASPS patients, not the local recurrence - that can be redone if it happens.
To get familiar with the controversy and a current status of evidence (or rather lack of it) read the following report
Appropriate Surgical Margins and Proper Handling of Soft Tissue Sarcoma of the Extremities
11-10 EBS: September 2012
Status: CURRENT
https://www.cancercare.on.ca/toolbox/qu ... rcoma-ebs/
"discuss the benefits and risks of accepting a very close margin that may even be
microscopically positive and the importance of preoperative or postoperative RT.
Local recurrences have been observed even when negative margins are achieved with surgery
and with surgery and radiation, suggesting that tumour characteristics other than margin
status are important. Further study is required."
Some of our patients get the radiation therapy, some do not. Radiation treatment always has long term damaging consequences even if they are not felt immediately
2. PET/CT every 3 months or not.
Follow up guidelines might be found here:
http://www.nccn.org/professionals/physi ... arcoma.pdf
there is no full body PET/CT recommended for any sarcoma, it is even less useful for ASPS.
The full body PET/CT means a fairly high radiation dose for the patient but no benefit versus plain CT as ASPS is a slow growing tumor and the metastases have to be fairly big to be lit on the PET scan - the size that would be found by the CT alone. May be once a year PET/CT would have some advantage. In our own experience even obvious mets less than 10 mm would not lit up on the PET scan.
None of our patients get PET/CT every 3 months.