Preoperative Radiotherapy for Sarcomas of the Extremities With Intensity-Modulation, Image-Guidance and Small Safety-margins

Inclusion Criteria: Histologic and radiographic proof of localized high-risk soft tissue sarcoma meeting the following criteria: * Lesion originates in extremity * upper extremity lesions may occur from the medial border of the scapula to tumors as far distal as the finger tips * lower extremity regions include hip girdle tumors commencing at the iliac crest, excluding lesions arising from within the pelvis, and extends to include lesions as far distal as the toes * AJCC Stage II or III disease (except T1a-tumors or N1) * Primary presentation or local recurrence * after biopsy or inadequate surgery resulting in residual tumor in cross-sectional imaging * Tumors must be considered resectable according to cross sectional imaging, or potentially resectable after preoperative radiotherapy * ECOG Performance Status 0-2 * Informed Consent Exclusion Criteria: * Diagnosis of the following: * Primitive neuroectodermal tumor * Soft tissue Ewing's sarcoma * Extraskeletal osteo- or chondrosarcoma * Aggressive fibromatosis (desmoid tumors) * Dermatofibrosarcoma protuberans * Regional nodal disease or unequivocal distant metastasis * Life expectancy \< 1 year * Pregnancy * Major medical illness that would preclude study treatment * History of major wound complication or recurrent skin infection * Known HIV positivity * \< 2 weeks elapsed from prior surgery or cytotoxic chemotherapy * persisting acute toxicities \> grade 1 in tumor-bearing limb resulting from prior treatment with anti-cancer modalities * Cytotoxic chemotherapy, targeted therapy or investigational agents concurrent to study treatment * Prior radiotherapy to the site of present STS. * Chronic requirement for treatment with immuno¬suppressive agents or steroids.