Mertens W C, Bramwell V H
Department of Oncology, University of Western Ontgario, London, Canada.
Clin Orthop Relat Res. 1993 Apr(289):81-93.
Standard therapy for treatment of soft-tissue sarcoma dictates adequate surgical resection with or without radiation therapy. However, metastases occur in a substantial proportion of cases, and, if improvement in survival is to be obtained, elimination of hematogenously borne micrometastasis will be required. A number of randomized, controlled clinical trials have been performed evaluating the use of cytotoxic chemotherapy in the treatment of localized soft-tissue sarcoma. Single-arm studies evaluating the use of intraarterial chemotherapy as an adjunct to limb-sparing surgery have been reported. Many of these studies have methodologic weaknesses, and have yielded conflicting results. Reviewed in detail, these studies are evaluated in the light of opportunities for clinical research.
软组织肉瘤的标准治疗方法要求进行充分的手术切除，可联合或不联合放射治疗。然而，相当一部分病例会发生转移，若要提高生存率，就需要消除血行播散的微转移灶。已经开展了多项随机对照临床试验，评估细胞毒性化疗在局限性软组织肉瘤治疗中的应用。也有报告称进行了单臂研究，评估动脉内化疗作为保肢手术辅助治疗的应用。这些研究中有许多存在方法学上的缺陷，且结果相互矛盾。详细回顾后，根据临床研究的机会对这些研究进行了评估。
