The role of adjuvant chemotherapy for soft tissue sarcomas is not fully established. The combination of doxorubicin , high-dose cyclophosphamide and high-dose methotrexate may be of value. Several trials have shown a reduction in local recurrence if chemotherapy is combined with radiation or if radiation therapy is combined with surgery for the treatment of the primary tumor .
• In Metastatic Disease The treatment of metastatic disease in both bone and soft tissue sarcomas usually
involves the use of chemotherapy. If tumors are confined to the lungs, an attempt may be made to surgically
remove the metastatic deposits. Removal of only a small wedge or triangular-shaped portion of the lung may
be needed, rather than the entire lung or a major portion of it. Chemotherapy is sometimes used preoperatively
in an attempt to shrink the metastases.
Investigational
• Current investigational protocols for soft tissue sarcoma include the use of chemotherapy before surgery
(neoadjuvant) in primary soft tissue sarcomas and trials of new drugs in advanced disease.
• There are investigational protocols for patients with high-risk Ewing's sarcoma (large tumors in the pelvis) that
don't respond well to preoperative treatment. As well as the standard chemotherapy, radiation and surgery,
patients are now being entered into trials of high-dose chemotherapy and autologous bone marrow
