How would you approach therapy in a young adult with synovial sarcoma of the head and neck who is not amenable to surgery due to location on the face?  

I do not think primary synovial sarcoma is curable without surgery. I have never seen a durable response in a tumor treated with radiation alone. Synovial sarcoma responds to ifosfamide based chemotherapy generally, but in my experience, the response rates for primary tumors are lower than response ...

Unlikely to cure without surgery. GTR and postop RT. If not suitable for GTR, RT and prayer.