Osteosarcoma is considered relatively insensitive to RT and it is not generally recommended for use as local control.
RT is generally used in sites where wide local excision is not possible or would lead to unacceptable morbidity.
In these circumstances proton therapy is often appropriate to give a course of very high dose fractionated RT to achieve local control.
In retrospective analyses of nonrandomized treatments, among patients who had no surgery or intralesional resection, patients who received radiation therapy had better survival than patients who did not receive radiation therapy.
Patients with osteosarcoma may benefit from radiation therapy if surgical margins are inadequate.