High-dose chemotherapy in adult sarcomas: no standard yet.

摘要: Abstract The management of patients with sarcoma involves a multidisciplinary approach, surgery, radiotherapy, and chemotherapy all playing their part. role high-dose in this heterogeneous rare disease remains controversial unproven. Adult soft tissue sarcomas (STS) generally are poorly responsive to standard chemotherapy, doxorubicin (DOX) ifosfamide (IFOS) being the only available agents showing response rates greater than 20%. Combination regimens do not add efficacy, but toxicity. For both active agents, dose-response relationship has been shown. Therefore, absence new better drugs or schedules, dose-intensifying even (HDCT) cellular support have studied. Unfortunately, most these trials were noncontrolled, studying patient groups. Furthermore, strategies never resulted significantly longer overall survival (OS), therefore remain highly investigational. Primarily, search for should be encouraged. Although HDCT cannot considered common practice STS, strategy as consolidation therapy well-defined subsets patients, using prognostic factors, could explored further carefully designed studies. Ewing tumor family (ET), distinct entity, is more systemic disease. Results from small, noncontrolled studies indicate that by megatherapy hematologic contributes an improved outcome "high-risk" compared historical controls. However, exact determined properly randomized groups appropriate sample sizes. collaboration between cooperative design execution sizes This approach might provide us essential answers enabling progress. In addition, each should, much possible, treated within context study.