Bone and soft tissue sarcomas represent about 1% of all cancers; there are approximately < 13, 000 new cases diagnosed annually. Moreover, there are at least 50 histologic sub-types of soft tissue sarcoma many of which exhibit distinct patterns of behavior. Because of the relative rarity and heterogeneity of these diseases, the majority of oncologists see very few patients with sarcoma in their practices. Yet, many patients with bone and soft tissue sarcoma are young and potentially curable with minimal functional morbidity. It is therefore important for oncologists to have a good working knowledge of the appropriate management of soft tissue sarcoma so that opportunities for cure with excellent functional outcome are not missed. This presentation of difficult cases will provide a representative overview of the diseases that comprise bone and soft tissue sarcoma. It will review practice management with emphasis on multi-modality patient assessment, decision making, and the respective roles of radiation therapy, surgery, and chemotherapy. Cases will include sarcomas of soft tissue and bone. Both standard and innovative modalities will be discussed and include 3D-conformal RT, IMRT with dose painting, proton treatment and novel brachytherapy techniques, as well as image-guided surgery. Areas of controversy, innovation and active clinical research will also be discussed. At the conclusion of this activity, the learner will be able to do the following: 1. Describe practice management of actual cases of Bone and Soft Tissue Sarcoma with emphasis on multi-modality patient assessment, decision making, role of radiation therapy and follow-up. 2. Discuss technical aspects of radiation treatment planning for patients with sarcoma of the soft tissues and bone. 3. Discuss new innovations in technology and treatment of sarcoma including the use of IMRT dose painting, brachytherapy, and protons as well as image-guided surgery.