Introduction

Liposarcoma is a rare cancer that starts in the body’s fat tissue. Although it’s uncommon, it is actually one of the more frequent types of soft tissue sarcoma – a cancer that develops in the body’s muscles, fat, nerves, or connective tissues. There are four main types: well-differentiated, dedifferentiated, myxoid, and pleomorphic.¹ 

Each type behaves differently. Some grow slowly and are less aggressive, while others can spread quickly and are harder to treat. For example, dedifferentiated liposarcomas tend to grow faster, spread more easily, and are more likely to come back even after treatment.

Treatment depends on the type and stage of the cancer. Surgery is usually the best way to remove the tumour completely, but radiation therapy (using targeted high-energy rays) can help shrink the tumour before surgery or control it afterwards. This article explains when radiation therapy might be used for liposarcoma, what results you can expect, and how it fits into overall treatment plans.¹ 

Indications for radiation therapy in liposarcoma

Radiation therapy is a cancer treatment that uses powerful energy beams to damage cancer cells so they can’t keep growing. In liposarcoma, whether or not you receive radiation depends on factors such as the size of the tumour, its location, and its aggressiveness.

If the tumour is large or sits close to important organs or nerves, radiation is often used alongside surgery. In many cases, it is given before the operation – this is called neoadjuvant radiation – to shrink the tumour and make it easier for the surgeon to remove. This is especially important for faster-growing, high-grade tumours.² 

If the tumour is large or sits close to important organs or nerves, radiation is often used alongside surgery. In many cases, it is given before the operation – this is called neoadjuvant radiation – to shrink the tumour and make it easier for the surgeon to remove. This is especially important for faster-growing, high-grade tumours.³

Another reason to use radiation is when surgery cannot remove all of the tumour with a clear margin, meaning some cancer cells may still be at the edge of the removed tissue. Post-surgery radiation can target and destroy these remaining cells, reducing the risk of the cancer returning.⁴ 

Sometimes surgery isn’t possible at all. Radiation can then be used to control symptoms, ease discomfort, and improve quality of life, even in the later stages of the illness. Research shows that in some cases, a single session of radiation can be as effective as multiple sessions for symptom relief, without making treatment unnecessarily long or tiring.⁵

Outcomes of radiation therapy

Radiation therapy can improve control of liposarcoma, meaning it lowers the risk of the cancer coming back in the treated area. When combined with surgery, it often works well for certain types, especially well-differentiated and myxoid liposarcomas. Pleomorphic liposarcoma, however, tends to respond less well.⁶ The outlook for patients depends on the type of liposarcoma and how far it has progressed. Well-differentiated liposarcoma generally has the best results, with survival rates at 5 and 10 years being around 82% and 68% respectively. Myxoid liposarcoma comes next, followed by pleomorphic and dedifferentiated types, with the latter having the poorest outlook. Age and general health can also make a difference – older patients or those with other health conditions often face more challenges.⁷ 

​​One type in particular, myxoid liposarcoma, is especially sensitive to radiation. When combined with surgery, the results are often excellent, with high rates of local control. For well-differentiated liposarcoma, surgery is usually the main treatment, but radiation can still be useful in certain situations – for example, if the surgery leaves behind positive margins. For tumours in the limbs or trunk, radiation can help protect function. By shrinking the tumour before surgery, it can make the operation less invasive, helping to avoid more drastic procedures that might affect movement or organ use. In these cases, radiation doesn’t just help control the cancer – it can also help patients maintain a better quality of life.^8,9 

Complications and side effects

Like most cancer treatments, radiation therapy can cause some side effects, and these vary from person to person. The most common ones include:

• Red or dry skin in the treated area
• Feeling sick (nausea) or sometimes being sick (vomiting)
• A change in appetite
• Feeling unusually tired
• Hair loss in the treated area¹⁰  

These side effects happen because radiation, while targeting cancer cells, can also affect healthy cells that grow and repair themselves quickly, like those in the skin, mouth, and digestive system. When these healthy cells are temporarily damaged, it can cause symptoms such as redness, soreness, mouth ulcers, or an upset stomach.¹¹ For most people, these effects begin during treatment or within a few weeks afterwards. They are usually temporary and improve with time once treatment ends. In longer treatment courses, some people may experience more persistent effects, but your care team will work with you to manage them and keep you as comfortable as possible.

Factors influencing the outcome

How well radiation therapy works for liposarcoma – and how someone feels afterwards – can depend on several things.

One of the biggest influences is the type of liposarcoma and whether it’s considered “high grade” (more aggressive) or “low grade” (slower-growing). High-grade tumours often need more intensive treatment and can have a higher chance of coming back.

​​Other factors include:

• How sensitive the affected tissue is to radiation
• The size of the area being treated
• The total amount of radiation given and how it’s spread out over time
• Whether the person also has surgery or chemotherapy alongside radiation
• The severity of any short-term side effects during treatment

A person’s age and general health can also make a difference – for example, older patients or those with other health problems may find recovery takes longer. In some cases, family history can play a role too. People with close relatives who have had liposarcoma or certain other cancers may have a slightly higher risk of a more challenging outcome.¹² 

Your medical team will take all of these factors into account when planning treatment, so it’s as effective and safe as possible for you.

Summary 

Radiation therapy can play an important role in treating liposarcoma, but whether it’s used – and how effective it is – depends on several things. These include the type of liposarcoma, how aggressive it is, where in the body it’s found, and whether it has spread.

For some people, surgery is the first step, followed by radiation. For others, radiation may come before surgery to shrink the tumour and make it easier to remove. Tumours in certain areas – like the limbs, groin, or torso – may be treated differently to help preserve function and quality of life.

While radiation therapy often gives promising results, especially in some subtypes, it isn’t always a guaranteed cure. That’s why treatment needs to be tailored to each person. Your care will usually be planned by a team of specialists – including surgeons, oncologists, and radiologists – who work together to find the safest and most effective approach for you.

FAQs

What side effects might I experience from radiotherapy for liposarcoma?

Some people notice redness or dryness of the skin in the treated area, tiredness, or changes in appetite. You might also feel a bit sick or lose some hair where the radiation is given. These effects are usually temporary, and your healthcare team can help you manage them.

Is there anything I should avoid while having radiotherapy?

It’s important to be gentle with the skin in the treated area. Avoid direct sunlight, hot baths, or harsh skincare products. Your radiotherapy team will give you tips to protect your skin and keep you comfortable.

Will I lose weight during radiotherapy?

Some people do lose weight during treatment, but this isn’t always the case. Changes in appetite, taste, or digestion can affect your weight. If this happens, your care team can refer you to a dietitian to help you maintain your strength.

What is usually the best treatment for liposarcoma?

For most people, surgery is the main treatment. Radiotherapy is sometimes used before or after surgery to shrink the tumour, help the surgeon remove it more easily, or lower the chance of it coming back.

Which type of liposarcoma is the most aggressive?

Pleomorphic liposarcoma is one of the rarer but more aggressive types. This means it tends to grow and spread faster, so treatment often needs to be started promptly.