Adjuvant Treatment of Soft Tissue Sarcoma in Children and Adults

  • V. H. C. Bramwell
  • P. A. Voûte
  • S. A. Rosenberg
  • H. M. Pinedo
Part of the Recent Results in Cancer Research book series (RECENTCANCER, volume 68)


Soft tissue sarcomas are a rare group of tumours comprising approximately 1% of all malignant tumours. Conventional management has relied heavily on surgery, but the inadequacy of this approach is reflected by local recurrence rates of 40%–80% in adult sarcomas and as high as 90% in childhood sarcomas. Cantin [3] in a review of 784 patients found that 382 had died of sarcoma and 65% had developed metastases concomitantly with local recurrence. The high local relapse rate is due to absence of encapsulation of the tumour, which spreads along fascial planes and nerve trunks and possibly also to a multifocal origin. Thus, more adequate methods of local control and prevention of dissemination are required and these include radiotherapy, chemotherapy and immunotherapy.


Adjuvant Chemotherapy Soft Tissue Sarcoma High Dose Methotrexate Clear Cell Sarcoma Alveolar Soft Part Sarcoma 
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  1. 1.
    Atkinson, L., Garvan, J. M., Newton, N. C.: Behaviour and management of soft connective tissue sarcomas. Cancer 16, 1552–1562 (1963).PubMedCrossRefGoogle Scholar
  2. 2.
    Benjamin, R. S., Gottlieb, J. A., Baker, L. O., Sinkovics, J. G.: Cyvadic vs. Cyvadact: a randomised trial of Cyclophosphamide, Vincristine and Adriamycin + DTIC or Actinomycin D in metastatic sarcomas. Proc. Am. Ass. Cancer Res. 17, 256 (1976).Google Scholar
  3. 3.
    Cantin, J., McNeer, G. P., Chu, F. C., Booher, R. J.: The problem of local recurrence after treatment of soft tissue sarcoma. Ann. Surg. 168, 47–53 (1968).PubMedCrossRefGoogle Scholar
  4. 4.
    Chung, E. B., Enzinger, F. M.: Infantile fibrosarcoma. Cancer 38, 729–739 (1976).PubMedCrossRefGoogle Scholar
  5. 5.
    Donaldson, S. S., Castro, J. R., Wilbur, J. R., Jesse, R. H.: Rhabdomyosarcoma of head and neck in children — combination treatment by surgery, irradiation and chemotherapy. Cancer 31, 26–35 (1973).PubMedCrossRefGoogle Scholar
  6. 6.
    Filber, F. R., Morton, D. L.: Sarcoma specific antigens: detection by complement fixation with serum from sarcoma patients. J. Natl. Cancer Inst. 44, 651–656 (1970).Google Scholar
  7. 7.
    Enzinger, F. M., Shiraki, M.: Alveolar rhabdomyosarcoma. Cancer 24, 18–31 (1969).PubMedCrossRefGoogle Scholar
  8. 8.
    Griswold, D. F., Laster, W. R., Schabel, F. M.: Therapeutic potentiation by Adriamycin and DTIC against B16 melanoma, C3H breast carcinoma, Lewis lung carcinoma and Leukaemia L1210. Proc. Am. Ass. Cancer Res. 14, 15 (1973).Google Scholar
  9. 9.
    Gottlieb, J. A., Baker, L. J., O’Bryan, R. M., Sinkovics, J. G., Hoogstraten, B., Quagliana, J. M., Rivkin, S. E., Bodey, G. P., Rodriguez, V. T., Blumenschein, G. R., Saiki, J. H., Coltman, C., Burgess, M. A., Sullivan, P., Thigpen, T., Bottomley, R., Balcerzak, S., Moon, T. E.: Adriamycin (NSC-123127) used alone and in combination for soft tissue and bone sarcoma. Cancer Chemother. Rep. (Part. 3) 6, 271–282 (1975).Google Scholar
  10. 10.
    Gottlieb, J. A., O’Bryan, R. M., Moon, T. E., Bodey, G. P., Sinkovics, T., Thigpen, T., Rivkin, S. E.: Improved survival with Adriamycin combinations vs. Adriamycin alone in patients with metastatic sarcoma. Proc. Am. Soc. Clin. Oncol. 16, 238 (1975).Google Scholar
  11. 11.
    Gottlieb, J. A., Benjamin, R. S., Baker, L. H., O’Bryan, R. M., Sinkovics, J. G., Hoogstraten, B., Quagliana, J. M., Rivkin, S. E., Bodey, G. P., Rodriquez, V., Blumenschein, G. R., Saiki, J. H., Coltman, C., Burgess, M., A., Sullivan, P., Thigpen, T., Bottomley, R., Balcerzak, S., Moon, T. E.: Role of DTIC (NSC-45388) in the chemotherapy of sarcomas. Cancer Treat. Rep. 60, 199–203 (1976).PubMedGoogle Scholar
  12. 12.
    Hellman, K., Ryall, R. D. H., Macdonald, E., Newton, K. A., James, S. E., Jones, S.: Comparison of radiotherapy with and without Razoxane (ICRF 159) in the treatment of soft tissue sarcomas. Cancer 41, 100–107 (1978).CrossRefGoogle Scholar
  13. 13.
    Heyn, R. M., Holland, R., Newton, H. A., Teft, M., Breslow, N., Hartmann, J. R.: The role of combined treatment of rhabdomyosarcoma in children. Cancer 34, 2128–2142 (1974).PubMedCrossRefGoogle Scholar
  14. 14.
    Horn, R. C., Enterline, H. T.: Rhabdomyosarcoma: a clinicopathological study and classification of 39 cases. Cancer 11, 181–199 (1958).PubMedCrossRefGoogle Scholar
  15. 15.
    Malpas, J. S., Freeman, J. E., Paxton, A., Walker-Smith, J., Stansfield, A. G., Wood, B. B. S.: Radiotherapy and adjuvant combination chemotherapy for childhood rhabdomyosarcoma. B. M. J. 1, 247–249 (1976).CrossRefGoogle Scholar
  16. 16.
    McNeer, G. P., Cantin, J., Chu, F., Nickson, J. J.: Effectiveness of radiation therapy in the management of sarcoma of the soft somaticissues. Cancer 22, 391–397 (1968).PubMedCrossRefGoogle Scholar
  17. 17.
    Morton, D. L., Filber, F. R., Townsend, C. M., Grant, T. T., Mirra, J., Weisenburger, T. H.: Limb salvage from a multidisciplinary approach for skeletal and soft tissue sarcoma of the extremity. Ann. Surg. 184, 268–278 (1976).PubMedCrossRefGoogle Scholar
  18. 18.
    Perry, H., Chu, C. H.: Radiation therapy in the palliative management of soft tissue sarcomas. Cancer 15, 179–183 (1962).PubMedCrossRefGoogle Scholar
  19. 19.
    Pilot Study EORTC (unpublished).Google Scholar
  20. 20.
    Pinedo, H. M., Vendrick, C. P. J., Staquet, M., Kenis, Y., Sylvester, R.: EORTC randomised trial for therapy of metastatic soft tissue sarcoma, Protocol 62761. March 1977. Eur. J. Cancer. (in press) (1978).Google Scholar
  21. 21.
    Pinedo, H. M., Voûte, P. A.: Combination chemotherapy in soft tissue sarcoma. In: Recent advances in cancer treatment. Tagnon, H. J., Staquet, M. J., (eds.). New York: Raven Press 1977.Google Scholar
  22. 22.
    Pinkel, D.: Cyclophosphamide in children with cancer. Cancer 15, 42–49 (1962).PubMedCrossRefGoogle Scholar
  23. 23.
    Pratt, C. B., James, D. H., Holton, C. P., Pinkel, C.: Combination therapy including Vincristine for malignant solid tumours in children. Cancer Chemother. Rep. 52, 489–495 (1968).PubMedGoogle Scholar
  24. 24.
    Pratt, C. B., Hustu, H. O., Fleming, I. D., Pinkel, D.: Coordinated treatment of childhood rhabdomyosarcoma with surgery, radiotherapy and combination chemotherapy. Cancer Res. 32, 606–610 (1972).PubMedGoogle Scholar
  25. 25.
    Rosenberg, S. A., Kent, H., Costa, J., Webber, B. L., Young, R., Chabner, B., Baker, A. R., Brennan, M. F., Chretien, P. B., Cohen, M. H., Demoss, E. V., Sears, H. F., Seidp, C., Simon, R.: Prospective randomised evaluation of the role of limb sparing surgery, radiation therapy and adjuvant chemotherapy in the treatment of adult soft tissue sarcomas. Surgery. July 1978.Google Scholar
  26. 26.
    Russel, W. O., Cohen, J., Enzinger, F., Hadju, S. I., Heise, H., Martin, R. G., Meissner, W., Miller, W. T., Schmitz, R. L., Suit, H. D.: A clinical and pathological staging system for soft tissue sarcomas. Cancer 40, 1562–1570 (1977).CrossRefGoogle Scholar
  27. 27.
    Skipper, H. E.: Adjuvant chemotherapy. Cancer 41, 936–940 (1978).PubMedCrossRefGoogle Scholar
  28. 28.
    Sordillo, P., Magill, G. B., Howard, J., Golbey, R. B.: Adjuvant chemotherapy of adult soft part sarcomas with ‘ALOMAD’. Proc. Am. Soc. Clin. Oncol. 19, 353 (1978).Google Scholar
  29. 29.
    Stobbe, G. D., Dargeon, H. W.: Embryonal rhabdomyosarcoma of the head and neck in children and adolescents. Cancer 3, 826–836 (1950).PubMedCrossRefGoogle Scholar
  30. 30.
    Suit, H. D., Russel, W. O., Martin, R. G.: Sarcoma of soft tissue: clinical and histopathological parameters and response to treatment. Cancer 35, 1478–1483 (1975).PubMedCrossRefGoogle Scholar
  31. 31.
    Sutow, W. W., Sullivan, M. P., Ried, H. L., Taylor, H. G., Griffith, K. M.: Prognosis in childhood rhabdomyosarcoma. Cancer 25, 1384–1390 (1970).PubMedCrossRefGoogle Scholar
  32. 32.
    Sutow, W. W., Berry, D. H., Haddy, T. B., Sullivan, M. P., Watkins, W. L. Windmiller, J.: Vincristine sulfate therapy inn children with metastatic soft tissue sarcoma. Paediatrics 38, 465–472 (1966).Google Scholar
  33. 33.
    Tan, C. T. C., Dargeon, H. W., Burchenall, J. H.: Effect of Actinomycin D on cancer in childhood. Paediatrics 24, 544–561 (1959).Google Scholar
  34. 34.
    Townsend C. M. Eilber F. R. Morton D. L. Skeletal and soft tissue sarcoma Results of treatment with adjuvant immutherapy J.A.M.A. 236 2187–2189 1976PubMedCrossRefGoogle Scholar
  35. 35.
    Townsend, C. M., Eilber, F. R., Morton, D. L.: Skeletal and soft tissue sarcomas: results of surgical adjuvant chemotherapy. Proc. Am. Ass. Cancer Res. 17, 265 (1976).Google Scholar
  36. 36.
    Windeyer, B., Dische, S., Mansfield, C. M.: The place of radiotherapy in the management of fibrosarcoma of soft tissues. Clin. Radiol. 17, 32–40 (1966).PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin · Heidelberg 1979

Authors and Affiliations

  • V. H. C. Bramwell
  • P. A. Voûte
  • S. A. Rosenberg
  • H. M. Pinedo

There are no affiliations available

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