Pinedo H M, Verweij J
Radiother Oncol. 1986 Mar;5(3):193-205. doi: 10.1016/s0167-8140(86)80049-4.
Radical surgery remains the most effective treatment of soft tissue sarcomas. The postoperative addition of radiotherapy appears to reduce local recurrence in extremity lesions. To date, there are still only two drugs with major activity as a single agent in the treatment of soft tissue sarcomas: doxorubicin (DX) and ifosfamide (IFX). Doxorubicin should be administered preferably as 3-weekly bolus injections at doses higher than 60 mg/m2 because of its dose-response relationship. In combination chemotherapy ADIC and CYVADIC are probably the best choice. Although there are no definite data on increased activity with the addition of cyclophosphamide (CTX) and vincristine (VCR) to ADIC, we prefer CYVADIC because of the higher reported complete response rate. A limited number of patients with soft tissue sarcomas achieving a complete response with chemotherapy, will probably be cured, and for this reason it is important to aim at achieving a complete response. Preoperative intraarterial chemotherapy in locally advanced soft tissue sarcomas may further improve survival results, but before definite conclusions can be drawn, this technique should be investigated in randomized studies. Postoperative adjuvant chemotherapy should still be considered investigational, as no advantage has been observed in head, neck and trunk lesions, while data on extremity lesions are still conflicting.
根治性手术仍然是软组织肉瘤最有效的治疗方法。术后加用放疗似乎可降低肢体病变的局部复发率。迄今为止，在软组织肉瘤治疗中作为单一药物具有主要活性的药物仍只有两种：多柔比星（DX）和异环磷酰胺（IFX）。由于多柔比星的剂量反应关系，应优选每3周进行一次大剂量注射给药，剂量高于60mg/m²。在联合化疗中，ADIC和CYVADIC可能是最佳选择。虽然尚无明确数据表明在ADIC方案中加用环磷酰胺（CTX）和长春新碱（VCR）可提高活性，但由于报道的完全缓解率较高，我们更倾向于CYVADIC方案。少数经化疗获得完全缓解的软组织肉瘤患者可能会被治愈，因此，旨在实现完全缓解非常重要。局部晚期软组织肉瘤的术前动脉内化疗可能会进一步提高生存结果，但在得出明确结论之前，应在随机研究中对该技术进行研究。术后辅助化疗仍应视为试验性治疗，因为在头颈部和躯干病变中未观察到优势，而关于肢体病变的数据仍存在矛盾。
