Infusion Chemotherapy for Soft Tissue Sarcomas

Abstract

Adriamycin has formed the backbone of sarcoma chemotherapy since its introduction into clinical practice. The pioneering studies in this field by the late Dr. Jeffrey Gottlieb demonstrated modest but definite improvement in response rate, remission duration and survival when Adriamycin was combined with DIC and slight further improvement with the addition of cyclophosphamide [1–5]. Other drugs have been relatively ineffective, and the CyVADIC regimen, introduced in 1973, remains the standard of sarcoma chemotherapy [3–5]. Review of the data from our own institution from 1973–1977 revealed an 18% complete remission rate and a 49% complete plus partial remission rate in 169 patients treated with the CyVADIC regimen [6]. Patients who achieve complete remission have the potential for long term survival, and this is true whether the complete remission is a response to chemotherapy alone or to chemotherapy and surgery [7]. Unfortunately, maintenance chemotherapy without adriamycin has been ineffective, and the majority of patients relapse after adriamycin has been discontinued to prevent cardiac toxicity.