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Chemotherapy for advanced sarcoma: therapeutic decisions and modalities
1Division of Medical Oncology, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA.
Seminars in Oncology
|October 31, 1997
Summary
Systemic chemotherapy is recommended for advanced soft tissue sarcoma. Treatment decisions for advanced soft tissue sarcoma should balance quality of life with potential cure, considering patient age and performance status.
Area of Science:
- Medical Oncology
- Sarcoma Research
- Clinical Therapeutics
Background:
- Advanced soft tissue sarcoma requires systemic treatment when no longer localized.
- Treatment choices involve balancing quality of life, potential for remission, and cure.
Purpose of the Study:
- To review current systemic chemotherapy options for advanced soft tissue sarcoma.
- To guide treatment decisions based on patient characteristics and drug efficacy.
Main Methods:
- Review of available single-agent and combination chemotherapy regimens.
- Consideration of patient factors like age and performance status.
- Evaluation of drug response rates and toxicity profiles.
Main Results:
- Doxorubicin (or epirubicin) and ifosfamide demonstrate response rates >20% with a dose-response relationship.
- Dacarbazine shows activity in uterine leiomyosarcomas.
- Combination chemotherapy (e.g., doxorubicin-ifosfamide) offers higher response rates but increased toxicity.
Conclusions:
- Systemic chemotherapy is the primary approach for advanced soft tissue sarcoma.
- Personalized treatment strategies are crucial, including watchful waiting for some and clinical trials for others.
- Ongoing research into molecular biology and drug resistance offers future therapeutic hope.