When treating a soft tissue sarcoma close to humeral head, what humeral head dose constraint should be used?
I am treating a resected high grade liposarcoma with positive surgical margins to 66Gy. I would prefer to use IMRT to spare the humerus, but I can't find a suggested dose constraint in the literature.
Answer from: Radiation Oncologist at Community Practice
This is a fantastic question particularly in light of your absolutely correct assessment that the literature is silent on this issue. And osteonecrosis of the humeral head and humeral fractures have certainly been reported (e.g. Rossleigh et al (1986) Cancer); this coupled with a potential arthriti...