Sauer H
Medizinische Klinik III, Klinikum Grosshadern, Ludwig-Maximilians-Universität München.
Strahlenther Onkol. 1995 Apr;171(4):185-94.
Patients with high-grade soft-tissue sarcomas have a bad prognosis because of frequent generalisation especially with lung metastases. The question is if there is a chance to modify the prognosis of these high risk patients by any form of adjuvant chemotherapy.
Published randomised studies with a no-chemotherapy control arm are reviewed. The most important criteria are disease-free survival and especially overall survival.
Postoperative adjuvant chemotherapy for high-grade soft-tissue sarcomas is still investigational. This holds true for all localisations: e. g. extremities, head and neck, trunk. More clinical studies are needed to establish any indication for routine application of cytostatic drugs in this setting. Other experimental procedures are also not yet prepared for widespread use outside of clinical trials: pre-operative ("neoadjuvant") induction chemotherapy, regional perfusion with cytostatics (+/- hyperthermia) or externally applied deep regional tumor hyperthermia with systemic chemotherapy. From the actual knowledge it should be concluded that the uncontrolled adjuvant treatment of soft-tissue sarcomas with cytostatic drugs might provoke more risks of side effects than gain in survival.
高级别软组织肉瘤患者预后较差，因为其常发生转移，尤其是肺转移。问题在于是否有机会通过任何形式的辅助化疗来改善这些高危患者的预后。
对已发表的设有非化疗对照组的随机研究进行综述。最重要的标准是无病生存期，尤其是总生存期。
高级别软组织肉瘤术后辅助化疗仍处于研究阶段。所有部位均是如此，例如四肢、头颈部、躯干。需要更多临床研究来确定在这种情况下常规应用细胞毒性药物的任何适应证。其他实验性程序也尚未准备好在临床试验之外广泛应用：术前（“新辅助”）诱导化疗、细胞毒性药物区域灌注（±热疗）或全身化疗联合外用深部区域肿瘤热疗。根据目前的知识可以得出结论，用细胞毒性药物对软组织肉瘤进行无对照的辅助治疗可能引发更多副作用风险，而不是提高生存率。
