The role of chemotherapy in the treatment of adult soft tissue sarcomas

O'Byrne, Kenneth J. & Steward, W. P. (1999) The role of chemotherapy in the treatment of adult soft tissue sarcomas. Oncology, 56(1), pp. 13-23.

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Abstract

Adult soft tissue sarcomas are relatively rare tumours which are curable with radical surgery. Approximately 50% of patients will develop inoperable disease or metastases for which chemotherapy may be inappropriate. Only two cytotoxic agents - doxorubicin and ifosfamide - have activity in > 20% of patients. For both these agents there is evidence of a dose-response relationship. There is currently no good evidence that combination chemotherapy confers a clinical benefit compared with single agents. Outside a clinical trial, standard first-line therapy should be with single agent doxorubicin at a dose intensity ≥ 70 mg2 every 3 weeks. Approximately 25% of patients may be expected to respond to this regimen. There is the suggestion that responses may occur to ifosfamide in patients who progress on doxorubicin. The role of chemotherapy in the adjuvant setting remains uncertain. Several trials have suggested a modest relapse-free and overall survival benefit for the use of post-operative chemotherapy and a recent overview of 14 randomised trials confirms a small though significant benefit. These benefits have to be weighed against the toxicity of chemotherapy. The importance of treating all patients with soft tissue sarcomas in clinical trials is stressed. There is an urgent need to define new active agents to treat this disease.

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38 citations in Scopus
24 citations in Web of Science®
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ID Code: 65249
Item Type: Journal Article
Refereed: Yes
Additional URLs:
Keywords: Adult, Chemotherapy, Soft tissue sarcomas, alkylating agent, alpha interferon, carboplatin, cisplatin, colony stimulating factor 1, cyclophosphamide, dacarbazine, dactinomycin, doxorubicin, etoposide, fluorouracil, ifosfamide, methotrexate, muramyl tripeptide, paclitaxel, topotecan, vincristine, vindesine, bone marrow suppression, cancer adjuvant therapy, cancer survival, clinical trial, dose response, drug efficacy, drug toxicity, human, metastasis, priority journal, relapse, review, risk benefit analysis, soft tissue sarcoma, treatment outcome, Antineoplastic Agents, Antineoplastic Combined Chemotherapy Protocols, Humans, Randomized Controlled Trials, Sarcoma
DOI: 10.1159/000011924
ISSN: 0030-2414
Divisions: Current > Schools > School of Biomedical Sciences
Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Copyright Owner: Copyright 1999 S. Karger AG
Deposited On: 10 Dec 2013 02:11
Last Modified: 10 Dec 2013 02:11

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