Radiation Therapy for Bone Sarcoma in Adults

NYU Langone physicians may recommend radiation therapy, which involves the use of high levels of energy to kill cancer cells, to manage bone sarcoma. 


Radiation therapy is not usually an initial treatment for osteosarcoma. However, your doctor may sometimes use adjuvant radiation, or radiation therapy provided after the primary treatment, to increase the chance of stopping cancer growth at the site where the tumor first appeared.

Radiation therapy may also be used for osteosarcoma if you can’t undergo surgery because of another health condition, such as heart disease.

Ewing Sarcoma

Radiation therapy for Ewing sarcoma may be combined with chemotherapy before surgery, in order to reduce the odds of the tumor coming back. These treatments may also be combined before limb-sparing surgery to shrink the cancer, so surgeons can take out the tumor without damaging surrounding organs.

Radiation therapy may be used to treat people with Ewing sarcoma that has spread to other parts of the body. 


For chondrosarcoma, your doctor may use radiation therapy after surgery to maximize the chance of stopping cancer growth at the site where the tumor was found. It may also be used if your overall health prevents you from undergoing surgery.


Radiation therapy may be given to manage chordoma after surgery, reducing the chance that any remaining tumor may grow.

Treatment Planning and Guidance

NYU Langone radiation oncologists use special CT scans to create three-dimensional computerized images of the tumor and surrounding tissue and organs to customize therapy. These computerized images, used in conjunction with treatment-planning software, allow our doctors to treat a “virtual patient" first to determine how best to target the sarcoma and spare healthy tissue. 

Our physicians may also take frequent CT scans during treatment to ensure that radiation therapy precisely targets the tumor and avoids healthy tissue in the arms or legs as well as important organs, such as the lungs or heart. This approach, called image-guided radiation therapy, also helps to compensate for organ movement, such as that caused by breathing, during treatment.

Types of Radiation Therapy

NYU Langone physicians may use external beam radiation therapy, in which the energy is delivered to the tumor from outside the body using a machine called a linear accelerator. The machine rotates around you during therapy. Our doctors may also use brachytherapy, in which radiation is delivered from within the body.

Intensity Modulated Radiation Therapy

Tumors are often irregularly shaped. The intensity modulated radiation therapy approach, which uses a linear accelerator, allows your doctor to “sculpt” the radiation beams, adjusting their intensities in three dimensions to conform to the tumor. Targeting the radiation to the tumor in this way keeps healthy nearby tissues from being affected, reducing the risk of side effects.

Intensity modulated radiation therapy is usually delivered once a day, five days a week, for several weeks at NYU Langone. Breaking the treatment into smaller doses, called fractions, helps to deliver enough radiation to manage the tumor while reducing the risk of side effects.

Stereotactic Body Radiation Therapy

Rather than deliver the entire dose of radiation at one time, this form of treatment delivers a few high doses, called fractions, of carefully targeted radiation beams to the tumor for a period of several days to a week.

Your doctor may use stereotactic body radiation therapy for smaller sarcomas and for tumors that can’t be operated on. People who cannot undergo surgery may also be candidates for this procedure.


When a tumor is located near a critical blood vessel or nerve that is difficult to avoid with external beam radiation therapy, your doctor may use brachytherapy. This involves internal delivery of radiation. A surgeon places plastic catheters, or tubes, at the site where the sarcoma has been removed with surgery. These tubes run from the inside of your body to the outside through a small cut in the skin.

After surgery, doctors use these catheters to place a radioactive substance near any possible remaining cancer cells for a few minutes. The substance is then removed.

This method works to prevent the tumor from coming back. Treatments may take place twice a day for up to two days.

Managing Side Effects

Your team of NYU Langone doctors can plan radiation treatment to minimize side effects, such as peeling of the skin or nausea and vomiting. 

The doctors at Rusk Rehabilitation are available to help manage any complications and can prescribe a rehabilitation program to manage swelling in the arms and legs or stiffness in the joints caused by scar tissue.

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