High-Dose Proton/Photon RT + Surgery of Sarcomas of the Thoracic, Lumbar Spine/Sacrum

Inclusion Criteria: * Pathological diagnosis of malignant mesenchymal tumor of the thoracic/lumbar/spine/sacrum or paraspinal soft tissues involving nerve roots or extending into spinal canal. Inter-osseous bone sarcomas are to be managed by wide resectional surgery for patients that are medically operable. * Patient tumor status: 1) post biopsy or post resection with gross residual disease 2) post grossly complete resection but with margins positive or very close or tumor spill or cut through * Lesion may be primary or recurrent after prior surgery * No clinical, radiographic or other evidence of distant metastasis * Fit for the exposure of the affected vertebral segment * Life expectancy of greater than 36 months * KPS equal to or greater than 70 * 18 years of age or older * Declines radical surgery * No prior radiation treatment to the affected spine region Exclusion Criteria: * Pregnancy * Disease/conditions characterized by high radiation sensitivity. These include genetic diseases, such as ataxia telangiectasia. Major local conditions which are the local tolerance viz., multiple surgical procedures, serious local injuries. * No evident cord/cauda malfunction for causes other than effects of local tumor growth or due to metabolic effects of tumor